摘要:

We compared the extent of documentation of the diagnoses, vascular dementia and stroke, on inpatient (hospital) medical records and death certificates among 23 multi-infarct dementia index cases and 14 multi-infarct controls without cognitive dysfunction who were enrolled in a hospital-based case-control study and were followed longitudinally. Both the inpatient medical records and the death certificates markedly underdiagnosed vascular dementia when compared to the case-control study diagnosis. Furthermore, the diagnosis of stroke was grossly underdiagnosed on the death certificates. In lieu of the lack of medical record and death certificate documentation of vascular dementia, studies that utilize such information may be in considerable error. Clarification of the criteria for the diagnosis of vascular dementia and greater physician and public awareness of vascular dementia are needed.

ISSN:0251-5350    

DOI:10.1159/000110912

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Several hospital-based studies suggest a circadian rhythm for stroke, with a peak of onset in the morning. To verify whether these results could be confirmed in a community-based study, we used data from the SEPIVAC, a community-based stroke register in Umbria, Italy. Cerebral infarctions (48%), primary intracerebral hemorrhages (54%), subarachnoid hemorrhages (53%) and ''not known'' strokes (51%) were all more common between 6 a.m. and noon, and this peak was still present when strokes recognized on awakening were evenly redistributed over the sleep period. Looking at the subgroups of cerebral infarction, lacunar syndromes were more common during sleep. Cerebral infarctions were more frequent during winter, and primary intracerebral hemorrhages during autumn.

ISSN:0251-5350    

DOI:10.1159/000110913

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The mortality rates (MRs) for Parkinson''s disease (PD) and parkinsonism were analyzed for the period 1969–1987 in Italy, considering the population aged ≧ 25. MRs were then age-adjusted taking the 1981 Italian population as standard. We found an increase in MRs for PD during the period studied. The Italian average annual age-adjusted MR was 5.73, ranging from 4.76 (1969) to 6.81 (1985). Moreover we noticed some interesting differences in the geographic distribution of MRs between the five big areas Italy was divided into. We also found that, while the MR for the ages 65–79 years was quite constant in the period studied, there was a marked increase in the MR for ages >79 years from 1980 onwards. The geographic differences we found in MRs deserve to be analyzed in further epidemiological st

ISSN:0251-5350    

DOI:10.1159/000110914

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The methodology is presented of a large-scale study of epilepsy carried out in a highland area in northern Ecuador, South America, covering a population of 72,121 people; The study was carried out in two phases, the first, a cross-sectional phase, consisted of a house-to-house survey of all persons in this population, screening for epileptic seizures using a specially designed questionnaire. Possible cases identified in screening were assessed in a cascade diagnostic procedure applied by general doctors and neurologists. Its objectives were: to establish a comprehensive epidemiological profile of epileptic seizures; to describe the clinical phenomenology of this condition in the community; to validate methods for diagnosis and classification of epileptic seizures by a non-specialised team; and to ascertain the community''s knowledge, .attitudes and practices regarding epilepsy. A sample was selected in this phase in order to study the social aspects of epilepsy in this community. The second phase, which was longitudinal, assessed the ability of non-specialist care in the treatment of epilepsy. It consisted of a prospective clinical trial of antiepileptic therapy in untreated patients using two standard anti-epileptic drugs. Patients were followed for 12 months by a multidisciplinary team consisting of a primary health worker, rural doctor, neurologist, anthropologist, and psychologist. Standardised, reproducible instruments and methods were used. This study was carried out through co-operation between the medical profession, political agencies and the pharmaceutical industry, at an international level. We consider this a model for further large-scale studies of this type.

ISSN:0251-5350    

DOI:10.1159/000110915

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

HLA-A, -B, -C, -DR, -DQ antigens were studied in 11 multiplex MS families, 11 single-case MS families and 100 healthy subjects. The HLA DR4 was the most frequent antigen in all MS patients (p = 0.015). When the antigenic frequency in index familial cases was compared with that in single cases, the DR4 antigen was found to be more frequent (p = 0.01) in familial cases only. Furthermore, when the DR4 antigen was excluded from the analysis, we observed an increase in DR2 (p = 0.11) only in the familial MS cases. These results can be compatible with a multifactorial hypothesis according to which the HLA genes have an important role in MS susceptibility in familial cases.

ISSN:0251-5350    

DOI:10.1159/000110916

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Using data from 32 patients with symptom onset between 1943 and 1973, we described the occurrence of clinical neurologic multiple sclerosis (CNMS) in the Faroe Islands as then constituting three epidemics. We concluded that CNMS is the rare late result of infection with the primary MS affection (PMSA), a state requiring some 2 years of exposure for acquisition by Faroese. Our theses are that PMSA was first transmitted during World War II by affected but asymptomatic British troops to Faroese aged 11–45; that this (F1) cohort of affected asymptomatic Faroese under age 27 in 1945 transmitted PMSA to the next (F2) cohort of Faroese comprising those attaining age 11 each year from 1945 until F1 input ceased; that the F2 cohort similarly transmitted PMSA to the third (F3) cohort of Faroese. Cases of CNMS defining epidemics I-III were members of the respective F1–F3 cohorts. Within the F4 cohort of Faroese there is now a fourth epidemic of CNMS, with 7 patients with symptom onset between 1984 and 1989. Intermittency of the year of birth for CNMS cases is thus a reflection of membership in these separate population cohorts, and does not indicate ''protection'' in infancy or childhood. There is no evidence for an extra-Faroese source of MS after the first epidemic. No model of acute infection with short transmissibility fits the d

ISSN:0251-5350    

DOI:10.1159/000110917

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000110918

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000110919

出版商:S. Karger AG    

年代:1992

数据来源: Karger