ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00182.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Little information is available about stroke epidemiology in Eastern Europe. The purpose of our study was to determine and compare first‐ever stroke incidence, 30‐day case‐fatality rates, and frequency of some risk factors among stroke patients in four Siberian cities, representing western Siberia, mid‐eastern Siberia, and far eastern Siberia, Russia, during 1987–1988. There were 310 patients with first stroke in Novosibirsk, 447 in Krasnoyarsk, 51 in Tynda, and 24 in Anadyr. Age‐ and sex‐adjusted incidence of stroke was 216.1 per 100,000 residents annually in Novosibirsk, 365.4 in Krasnoyarsk, 324.2 in Tynda, and 347.7 in Anadyr; age‐ and sex‐adjusted 30‐day mortality rates were 31.9, 37.1, 22.3 and 18.3%, respectively. Among the identified patients with stroke, the prevalence of arterial hypertension was highest in Novosibirsk (79%), the prevalence of myocardial infarction and diabetes mellitus was highest in Krasnoyarsk (12 and 11%, respectively), and the prevalence of current smoking was highest in Anadyr (29%) and Tynda (28%). Age‐ and sex‐adjusted stroke incidence rates in Siberia are among the highest in the world. Stroke‐incidence rates tended to increase somewhat from west to east and from south to north across Siberia, although 30‐day mortality rates did not vary much in d

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00183.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In a randomized, multi‐centre, double‐blind, placebo‐controlled, parallel group study, the efficacy of 100 mg oral sumatriptan was compared with that of placebo in the treatment of episodic tension‐type headache. The patients were recruited from the general population in the vicinity of the study centres, by randomly mailed invitations. One or more attacks were treated with sumatriptan by 54 patients and with placebo by 57 patients. A seven‐point verbal rating scale was used for hourly assessments of headache relief, 1–4 h after treatment According to the predefined primary end‐point of the study, which was moderate or complete relief of headache 2 and 4 h after treatment of the first attack, there was no significant difference between sumatriptan and placebo treatment Sumatriptan did perform statistically significantly better than placebo at some time points, but the effect was not considered clinically relevant We conclude that sumatriptan should not be used in treatment of tension‐type headache. The marked difference in effect of sumatriptan in treatment of migraine and tension‐type headache argues against the idea that migraine and tension‐type headache are part of a continuum of

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00184.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Auditory event‐related potentials (ERP), multiple sleep latency tests, mini‐mental state exam, and depression tests were studied in 15 patients with obstructive sleep apnea syndrome (OSA). The P3 wave latency of ERP was significantly increased compared with 15 age‐matched control subjects. After 4 weeks and after 1 year of treatment of OSA by nasal continuous positive airway pressure (CPAP), there was no significant improvement in the abnormalities of ERP. These observed changes in ERP were not correlated with excessive daytime sleepiness, depression, nocturnal hypoxemia, and sleep fragmentation. The cause of increased P3 latency has not been elucidated, but a chronic cerebral insult was susp

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00185.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In this study a brain MRI long‐term follow‐up of 19 patients at presentation with Acute Isolated Optic Neuritis (AION), who did not develop further neurological disturbances, was performed to evaluate the frequency of subclinical evolution of the pathological process. At presentation, the brain MRI in nine patients was abnormal and in 10 normal. CSF oligoclonal bands were found in 11 patients, five of whom had normal basal MRI. All patients with abnormal basal MRI had new lesions on follow‐up scans, while only one of the patients with a normal basal brain MRI had multiple lesions on the second scan. Our data suggest that about 50% of patients with AION had subclinical activity, even though there were no new clinical rel

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00186.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Serial evaluation of forced vital capacity (FVC) were performed in 34 patients with amyotrophic lateral sclerosis, 28 of whom were followed until death. Successive evaluation of FVC in the same patient did not show a linear progression. An inflexion point was detected in most patients followed to death (81%) with initial normal FVC values. The decline was more rapid and survival time was less than 1 year in most patients after the inflexion point. Significant changes in FVC were characteristic of the second half of the course of the disease. FVC results are useful for determining the presence and degree of respiratory system involvement, but our results suggest that FVC alone cannot serve as a quantitative test in clinical trials, since most patients show a curvilinear slope in FVC deterioration instead of a linear slope.

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00187.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The levodopa dose‐sparing capacity of pergolide and bromocriptine, along with the maximum ability to improve activity of daily living and motor scores, were compared in 33 patients with idiopathic Parkinson's disease (Hoehn‐Yahr stage 2–4) in a 24‐week, open‐label, crossover study. Patients received one dopamine agonist for 12 weeks and then were crossed over to the other for 12 weeks (8 weeks, titration; 4 weeks, steady state in each period). The maximum doses allowed were pergolide 5 mg/day and bromocriptine 50 mg/day. As patients' clinical response to a dopamine agonist increased, the levodopa dose was decreased. Twenty‐seven patients completed the study. No serious adverse events or clinically significant changes in vital signs or laboratory tests were observed. The mean doses of bromocriptine and pergolide at the end of titration were 21.7 ± 5.6 mg (bromocriptine data for the two groups combined) and 3.6 ± 1.1 mg (pergolide data for the two groups combined), respectively. The mean levodopa dose was reduced 83% with bromocriptine as the first agent and increased 28.0% with bromocriptine as the second agent The mean levodopa dose was reduced 31.4% with pergolide as the first agent and 15.5% with pergolide as the second agent Levodopa could not be discontinued in any of the patients. Statistically significant levodopa dose‐sparing capacity and considerable clinical benefit were achieved with both agonists; however, the results were more favorable

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00188.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Toxoplasmosis of the spinal cord is an uncommon manifestation of the acquired immunodeficiency syndrome (AIDS). Previously described patients generally have had poor outcomes. We report a case of successfully treated, biopsy‐proven AIDS‐relatedToxoplasma gondiimyelitis (TGM) in a 39‐year old man who presented with a conus medullaris syndrome. A review of the literature and a suggested therapeutic approach to TGM are pres

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00189.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Current theory implicates mitochondrial defects in the mechanism of neuronal degeneration in several movement disorders. We performed analyses of mitochondrial function in 61 patients with different forms of degenerative ataxias. Mitochondrial enzyme defects were proven in five of 16 (31V.) patients with Friedreich's ataxia, in 14 of 30 (47%) patients with autosomal dominant late onset cerebellar ataxia, and in three of six (50%) patients with sporadic cerebellar atrophy. No abnormalities were found in secondary forms of cerebellar degenerations (due to paraneoplastic disorder, alcohol or sprue) or in spastic paraplegia. Mitochondrial defects affected most frequently the respiratory chain (19 patients) and especially its complex I (11 patients). Carnitine deficiency was found in three patients and severe loss of myoadenylate deaminase in one patient Genetic abnormalities could be proved neither in mitochondrial DNA nor in recently defined ataxia genes. Our results indicate that mitochondrial dysfunction occurs frequently in cerebellar atrophies. Therefore, disturbance of oxidative energy metabolism may be involved in the pathogenesis of degenerative ataxias, but it remains to be elucidated whether mitochondrial defects are primary or secondary effects.

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00190.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

We report a 14 year old patient who presented lung emboli and deep vein thrombosis in relationship to protein C deficiency. He had a carnitine‐deficient lipid myopathy. Fresh muscle homogenate showed low activities in oxidizing [1‐14C]‐butyrate, [1‐14C]‐octonoate and [1‐14C]‐palmitate. A deficient short chain butyryl‐CoA dehydrogenase (SCAD) was found in isolated muscle mitochondria. The patient improved dramatically with daily therapy of 200 mg riboflavin, 2 g carnitine and anticoagulation with Coumadin. The treatment was found to restore fatty acid oxidation in fresh muscle homogenate, deficient acylCoA‐dehydrogenases in mitochondria and decrease lipid droplets.These results suggest that in this type of lipid myopathy riboflavin supplementation may be effective. The link with protein C defici

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1996.tb00191.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY