摘要:

Dementia is a clinical and public health issue of growing importance as life expectancy increases across the planet. Despite advances in both genetic research and clinical management strategies, neither cure nor primary prevention is currently feasible. However, screening for dementia is critical for secondary prevention, i.e., early diagnosis and treatment as well as disability limitation and prevention of complications. Screening is also important for community surveillance and the planning of health and human services. The most appropriate screening approach for a particular clinical or research setting should be selected on the basis of the purpose of screening in that setting. Ideally, all elderly individuals, as well as younger persons with known risk factors, should be routinely screened for dementia. Availability of staff resources, including time and skills, should also be taken into account. Objective cognitive testing appears to be the most logical approach to screening for dementia. However, potential confounding variables and psychometric properties of the instruments should be considered. Ancillary measures such as functional disability scales, self-reported cognitive functioning, and informants'' perceptions may usefully supplement (or supplant) cognitive testing in certain populations. The limitations of screening should be recognized.

ISSN:0251-5350    

DOI:10.1159/000109697

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Researchers throughout the United States have developed an increased interest in recruiting minority groups into studies. Such increased interests have been encouraged by the federal agencies that have mandated diversity in study populations. This editorial attempts to explore salient issues pertinent to the recruitment and retention of African Americans and cites culturally specific recruitment strategies that have been successfully applied by investigators. African Americans may have special concerns that may have to be addressed by the investigators prior to initiation of the study. Concerns may include the fear of being treated as a ''guinea pig'' and the need for psychosocial programs. Such concerns require culturally sensitive strategies which may include trust-building and the provision of ancillary services. Although specific strategies are required to recruit and retain this special population in clinical studies, there are no guarantees that enrollment will be successful even with the inclusion of culturally sensitive mechanisms.

ISSN:0251-5350    

DOI:10.1159/000109698

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Changes in cognitive function were investigated in 566 subjects 65–86 years old at baseline, who are a subsample of the Western Collaborative Group Study, a cardiovascular epidemiologic study of middle-aged men that began in the 1960s. Cognitive function was assessed in 1986–1988 (baseline) and again in 1992–1994 by three standardized measures: the Benton Visual Retention Test, the Controlled Oral Word Association Test, and the Digit Symbol Substitution (DSS) Test. Longitudinal change in performance was defined as the shift over time in a subject''s quartile rank ordering, using the baseline distribution of test scores as a standard. ''Decliners'' and ''improvers'' in cognitive function were subjects who lost or gained, respectively, two or more quartile ranks on all three tests combined. By this definition, 20% (n = 113) of subjects declined, compared with 17% (n = 95) who improved in cognitive performance from 1986–1988 to 1992–1994. After adjustment for age, education, and physical health, decline in cognitive performance was significantly associated with poor self-perceived health ratings, depression scale scores, and self-reports of physical activity. Rank score change in the DSS Test was the single best predictor of cognitive function at follow-up on a diverse battery of neuropsychologi

ISSN:0251-5350    

DOI:10.1159/000109699

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

A community-based cross-sectional study was carried out in Ferrara, Northern Italy, to verify the frequency of gingival overgrowth in chronic phenytoin (PHT) users and the risk factors associated with its development. All subjects taking phenytoin were identified using the computerized list of drug prescriptions available in the study area. Most of the subjects were interviewed and underwent an oral examination to evaluate their periodontal condition. The prevalence of gingival enlargement in chronic PHT users was about 40%. In our study, sex, age, age at onset of therapy, treatment duration, and oral hygiene were not significantly associated with the risk of developing gingival overgrowth. A direct relationship with daily dose was found to be an independent risk factor. Younger age and poorer oral hygiene seemed to predispose to the severest level of gingival involvement. These results support data from experimental studies by suggesting that drug-induced gingival overgrowth is a dose-dependent side effect whose severity could be affected by local factors.

ISSN:0251-5350    

DOI:10.1159/000109700

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The previously reported prevalence of multiple sclerosis in Bulgaria is considerably lower than that reported for neighbouring countries. The aim of this study was to perform a detailed epidemiological investigation in well-defined populations in this country to obtain an accurate estimate of the frequency of multiple sclerosis. An epidemiological study was conducted in two small areas of the country. All patients with clinically or laboratory-supported, definite multiple sclerosis according to Poser''s criteria were personally interviewed. The study was begun in January, 1993 and December 31,1995 was selected as prevalence day. The prevalence ratio of multiple sclerosis per 100,000 population was 39.3 in the first community and 39.1 in the second. Thus, the prevalence ratio of multiple sclerosis in Bulgaria is not significantly different from that reported in bordering countries.

ISSN:0251-5350    

DOI:10.1159/000109701

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000109702

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Most population-based statistical reports of brain and central nervous system (CNS) tumors are limited to data of primary malignant tumors and to summary estimates of all tumor locations and histologies. We argue that data of benign brain and CNS tumors should also be included in registry reports and that standard definitions for the reporting of all brain and CNS tumors by site and histology should exist. We demonstrate current inconsistencies in the definitions of brain and CNS tumor sites used in reports. Grouping of brain and CNS tumors by subtype – which integrates the current World Health Organization classification scheme with the International Classification of Diseases for Oncology coding system used in cancer registries – is proposed. Adoption of standard tumor site and behavior codes for annual reports would aid the comparison of rates of brain and CNS tumors between geographic regions, allow for the evaluation of trends over time, and provide new estimates of tumor subtypes in a more clinically relevant format. A consensus among cancer registries and neuroscientists is needed to adopt standard definitions so that accurate and clinically relevant brain and CNS tumor data are availa

ISSN:0251-5350    

DOI:10.1159/000109703

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Study objective: To investigate whether people with occupational exposure to organic solvents have a higher prevalence of obstructive sleep apnea syndrome (OSAS) than the general population and to examine the relationship between snoring and exposure to organic solvents. Design and participants: Consecutive patients, aged 30-64 years, referred during a 3-year period to the sleep laboratory at Avesta Hospital, Sweden, because of suspected OSAS made up the patient groups. Following admission, patients underwent a simplified sleep apnea investigation and were divided into two groups, OSAS (n = 320) and snorers (n = 443). A random sample of 296 men and 289 women aged 30–64 years obtained from a register of all county residents maintained by the county tax authority served as referents (controls). Both patients and referents responded to two questionnaires, including questions about occupation, exposure to organic solvents, and other chemical and physical agents. Results: Men with OSAS or snoring and women with snoring had more often been occupationally exposed to organic solvents than the referents, showing an almost twofold increase in risk for those exposed during whole workdays. For men, the risk of OSAS or snoring increased with increasing exposure. Conclusion: The result indicates that occupational exposure to organic solvents might cause sleep apnea. A new observation is that even snoring could be caused by exposure to organic solvents. It is important to elucidate whether exposure to organic solvents is a cause of OSAS, because such a finding may have important implications for prevention and treatment of sleep disturbance

ISSN:0251-5350    

DOI:10.1159/000109704

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000109705

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000109706

出版商:S. Karger AG    

年代:1997

数据来源: Karger