摘要:

Tropical spastic paraparesis (TSP) is a chronic neurological syndrome of gradual onset involving the pyramidal tracts and upper motor neurons, resulting in weakness and stiffness of the lower extremities, hyperactive tendon reflexes, spasticity, low back pain, and urinary disturbances. Clusters of endemic TSP have been noted in Africa, the Seychelles Islands, Colombia, and the Caribbean. Recently, studies have linked human T-lymphotrophic virus type-I (HTLV-I) with the endemic form of the disease. In Japan a very similar clinical syndrome has been identified as HTLV-I-associated myelopathy and may be a nontropical version of the same disease. The purpose of the present review is to examine the role HTLV-I may play in the pathogenesis of these myelopathies from a neuroepidemiological point of view.

ISSN:0251-5350    

DOI:10.1159/000110173

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Surveying the disease by sending questionnaires to all physicians of the Saga Medical Association, we tabulated 19 definite cases of HTLV-I-associated myelopathy (7 males and 12 females) as of January 31, 1988. The population at risk of HTLV-I carriers was estimated by applying sex- and age-specific anti-HTLV-I antibody-positive rates among blood donors at the Saga Red Cross Blood Center in the fiscal year of 1986 to the population of Saga Prefecture in 1982. The crude prevalence rates among HTLV-I carriers from 20 to 69years of age per 100,000 were 65.7 for males and 86.9 for females, respectively. The summary prevalence rates with 95% confidence intervals were 46.5 (14.3–97.3) for males and 74.9 (35.3–129.2) for females. There was no remarkable difference in the age-specific prevalence rates in either sex. The crude and summary rates among females were higher than those among males, but the difference was not statistically signific

ISSN:0251-5350    

DOI:10.1159/000110174

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A case-control study was conducted among the multiethnic population of Singapore to test the hypothesis that a high level of body burden mercury is associated with an increased risk of Parkinson''s disease (PD). Selected factors investigated that could contribute to the body burden of mercury included dietary fish intake, ethnic over-the-counter medications, occupational exposures and possession of dental amalgam fillings. Detailed interviews were completed in 54 cases of idiopathic PD and 95 hospital-based controls, matched for age, sex and ethnicity, between July 1985 and July 1987. After adjusting for potential confounding factors, including dietary fish intake, medications, smoking and alcohol consumption, there was clear monotonic dose-response association between PD and blood mercury levels. The odds ratios (OR) and 95% confidence intervals (CI) for the approximate subject tertiles based upon blood mercury levels were 8.5 (CI = 2.2–33.2) and 9.4 (CI = 2.5–35.9), relative to the tertile with lowest blood mercury levels (< 5.8 ng Hg/ml). Similar associations were revealed using scalp hair and urinary mercury levels. However, only the comparisons between the highest and lowest tertiles were statistically different from unity (p < 0.05). When the body burden mercury indicators were mutually adjusted in addition to the four confounding factors, blood and urinary mercury levels showed ORs of 21.00 and 18.65, respectively. These ORs were statistically different from unity (p < 0.05, 2-sided test). After adjustment, scalp hair mercury was shown to be a poor predictor of PD r

ISSN:0251-5350    

DOI:10.1159/000110175

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The amyotrophic lateral sclerosis (ALS) severity scale has been developed to provide an ordinal staging system and a means of rapid functional assessment for patients with ALS. The scale allows an examiner to evaluate the symptoms of ALS numerically in four categories that describe speech, swallowing, lower extremity, and upper extremity abilities. These scores, combined with a vital capacity measured on a hand-held respirometer, provide a rapid, accurate assessment of a patient''s disease status and can be used for treatment planning. The ALS severity scale has been shown to have an average estimated reliability coefficient of 0.95 between examiners. Speech ratings were correlated >0.80 for objective speech measures. Rates of progression of the total score in a small group of patients ranged from –3.4 to –24.0 points/year with a mean of –11.3 points

ISSN:0251-5350    

DOI:10.1159/000110176

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A total of 186 cases of motor neuron disease (MND) was identified in two Danish counties during the period 1974–1986. The average annual incidence rate was 1.4/100,000 population, and the male:female ratio of incidence rates was 1.5. Mean age at diagnosis was 64.3 ± 10.0 years. The incidence rates increased significantly with advancing age and reached a maximum at age 60–79 years, followed by a nonsignificant decrease. The average point prevalence was 3.1/100,000 population. Bulbar symptoms were part of the initial symptoms in 65 % of cases, and patients with bulbar onset were older than patients with spinal onset. Age- and sex-specific incidence rates indicated a marked male preponderance amongst the youngest patients, in contrast to a female preponderance in patients above 60 years with bulbar onset of MND. Familial MND accounted for 2.7% of c

ISSN:0251-5350    

DOI:10.1159/000110177

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

From two prospective stroke studies during the period 1963–1968 and 1978–1982 at Bombay, using identical methodologies, it is observed that there is a significant drop in case fatality rate (32–12%) thereby resulting in a higher survival (68–88%) but with residual disability. Thus, these changing trends have posed a major social challenge in occupational rehabilitation and in solving the needs for stroke survivors, particularly in the younger age

ISSN:0251-5350    

DOI:10.1159/000110178

出版商:S. Karger AG    

年代:1989

数据来源: Karger