ISSN:0251-5350    

DOI:10.1159/000110952

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

To assess the incidence of febrile seizures in The Netherlands, we analyzed data from a population-based study carried out in 161 Dutch general practices. The overall incidence rate was 4.8/1,000 person-years. Considerable age and seasonal variation was found. The chance of a child suffering a febrile seizure in the course of the relevant age period (3–72 months) is 2.7%. One out of 3 children was referred to hospital. This is considerably less than in other countries. The incidence rates are similar to those found in the United States, England and Sweden, but differ from Asian studie

ISSN:0251-5350    

DOI:10.1159/000110928

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Seizures precipitated by the stimulus of hot water known as ''hot water epilepsy'' (HWE) have been commonly reported from South India. The present report outlines certain descriptive epidemiological aspects of 78 cases from two rural satellite clinics of National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India. Geographical clustering was observed in one of the centres. HWE was common in the age group of 26–35 years with a male to female ratio of 3.6:1. The frequency of seizure occurrence was more than 1–4 attacks/month in 89% of cases. Past history of febrile convulsions and family history of HWE was noticed in 27 and 18% of our cases, respectively. The conversion of reflex to nonreflex epilepsy occurred in 30.8% of cases. Population-based epidemiological studies are essential for further understanding of HWE for developing strategies towards prevention and cont

ISSN:0251-5350    

DOI:10.1159/000110929

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

215 patients with epilepsy and 125 healthy controls were questioned on the effects of epilepsy on social functioning as part of a population-based study of epilepsy in Northern Ecuador. 144 of these patients and 98 of the controls were followed, over a period of 1 year during an intervention study and then-response to treatment assessed. Economic, intellectual and social functioning were examined. In the patient group, function was affected in important areas, most clearly, work. The low opinion the community had of the intellectual and physical abilities of patients might affect a patient''s own view of themselves and sometimes diminish their opportunity for development. At 12 months, as a result of treatment, a significantly lower level of patients reported effects on function in some areas, though control individuals'' views of their functional impairment had not shifted to any extent. Moreover, despite improvement, more patients at 12 months acknowledged fear of seizures, especially their unpredictability, as a handicapping factor, particularly in working outside or away from home. This seems to indicate that even when seizures are controlled, for many patients, the uncertainties of the condition remain and continue to affect their view of their capabilities.

ISSN:0251-5350    

DOI:10.1159/000110930

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The short-term outcome after acute stroke is known to be strongly dependent on stroke subtype, especially favoring patients having suffered a lacunar stroke. The value of stroke subtypes as long-term predictors of survival has not been firmly established. We therefore examined the 1-year survival from acute stroke in the Klosterneuburg Stroke Data Bank, which since 1988 systematically collects data on acute stroke patients treated in one center in Lower Austria. The cumulative survival of 398 consecutive patients (mean age 67.7 ± SD 11.6) 1 year after a first-ever stroke was not only adversely related to age but also appeared to be age independent when compared according to stroke subtypes. The cumulative survival rates (CSR) ranged from 88.7 [95% confidence interval (CI): 82–92] for lacunar strokes (n = 107) to 68.1 (CI: 50–79) for atherothrombotic strokes (n = 69). Cardiogenic embolism (n = 68) showed a CSR of 72.1 (CI: 61–83) similar to the group of cryptogenic strokes (n = 121, CSR: 74.4, CI: 67–82). The CSR for primary intracerebral hemorrhage (n = 33) was 68.8 (CI: 53–85). It is concluded that the comparatively favorable prognosis of lacunar strokes must be recognized in trials designed to evaluate efficacy in terms of 1-year mortality. Furthermore, as cryptogenic stroke has an almost identical survival rate when compared to strokes caused by cardiogenic embolism it may be assumed that a considerable number of strokes for which no cause can be found are, in fact, cardiogen

ISSN:0251-5350    

DOI:10.1159/000110931

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Mortality form stroke in Italy over the period 1955–1987 was analysed in terms of age-specific, age-standardised death certification rates, and by means of a log-linear model to separate the effects of age, cohort of birth and calendar period of death. In males the overall age-adjusted rate on the world standard population fell from 118.4/100,000 population in 1955–1959 to 72.0 in 1985–1987 and in females from 94.8 in 1955–1959 to 54.7 in 1985–1987. The overall decline in age-standardised rates over the 3 decades was thus 39% for males (averaging 1.7%/year) and 42% for females (averaging 1.9%/year). The declines were even greater in truncated rates from 35 to 64 years: from 80.4 to 41.2/100,000 for males (49%), and from 63.0 to 24.1/100,000 for females (62%). Inspection of age-specific rates shows comparable falls – in relative terms – in early and later middle age. For instance, male rates declined from 70.4 to 38.1/100,000 (46%) at age 50–54, and from 1,151.1 to 584.2/100,000 (50%) at age 70–74. Only above age 75 were the falls smaller. In females aged 50–54 years the decline was 63%, and for those aged 70–74 years it was 59%. In young adults, no appreciable changes were observed in either sex. Thus, the age, period and cohort model showed downwards trends in both the period and cohort effect, except for the most recent cohorts on account of an age-cohort interaction. These favourable trends are discussed in relation to better control of hypertension and the potential impact of other risk factors. The absence of changes in the young suggests that other risk factors besides hypertension are probably involved in cerebrovascular disease mortalit

ISSN:0251-5350    

DOI:10.1159/000110932

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The validity of routine stroke data (official mortality statistics and hospital discharge registries) and a population-based MONICA stroke registry was assessed in a population of 309,806 25- to 74-year-old people in Sweden. The ''true'' number of strokes in the population was estimated by screening for non-stroke diagnoses in death certificates and hospital discharge records and by a period of intensified search for otherwise unrecognized non-hospitalized stroke cases. Applying strict stroke criteria, the proportion of false-positive diagnoses was 10% and false-negative 17% in official mortality statistics. Among patients discharged alive from hospital, there were 32 % false-positive and 6 % false-negative stroke diagnoses. In the MONICA registry, the proportion of false-negative cases was 6 % in fatal cases and 4% in non-fatal cases. Diagnostic information for subtyping stroke improved over time in non-fatal cases but remained essentially unchanged in fatal cases. We conclude that official mortality statistics give a reasonably good estimate of fatal stroke cases in Sweden, whereas hospital discharge records reflect poorly the incidence of stroke in the population. The overall quality of the population-based MONICA registry is good, although 4% of all strokes are missed. The proportion of unspecified stroke is substantial and changes over time; this makes longitudinal studies of stroke subtype difficult.

ISSN:0251-5350    

DOI:10.1159/000110933

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Epidemiological studies have demonstrated that environmental influences contribute to determining the risk of multiple sclerosis (MS). The nature of this influence has not been established, although infectious agents have received the most attention with relative neglect of alternative hypotheses. This paper critically reviews the evidence implicating dietary fat in altering susceptibility to MS. It is concluded that a dietary theory accords with current knowledge regarding MS as well as an infective theory and thus should not be dismissed in research examining the aetiology of MS.

ISSN:0251-5350    

DOI:10.1159/000110934

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Age at onset of multiple sclerosis (MS) symptoms was ascertained for subsets of some 4,400 veterans of World War II who had been adjudged ''service-connected'' for this condition. Average age at onset was 27.0 years for white men, 27.7 for white women, and 27.5 for black men. The unexpectedly older age for women is attributed to their older age at entry into service. When the coterminous United States was divided into three horizontal tiers of states, we found a strong effect of geography on age at onset. By state of residence at entry into active duty (EAD), white men had an average age at onset of 26.4 years in the northern tier, 27.3 years in the middle, and 28.8 years in the south. Trends were similar for white women and black men. Migrants, defined as those whose birth and EAD tiers differed, showed increasing ages at onset with southward moves. A statistical model used to discriminate between the influence of birth and EAD tiers on age at onset confirmed the significant effect of EAD alone. These data are compatible with the theses that the cause of MS is less common (or less efficient) in locations where the clinical disease is less common, and that its acquisition therefore occurs at an older age in those locales.

ISSN:0251-5350    

DOI:10.1159/000110935

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

A study has been undertaken to ascertain the changes in mortality from motor neurone disease (MND) and from multiple sclerosis (MS) in England and Wales and in the Republic of Ireland. During the 20 years 1968–1987, 16,077 deaths were reported as being primarily due to MND in England and Wales with a male/female ratio of 1.22. There has been an increase in MND deaths from 3,185 in 1968–1972 to 5,241 in 1983–1987. The increase occurred in the death rates in both sexes and in all age groups, but particularly over the age of 65. In contrast, there was no increase in MS deaths and the MS death rates fell below the age of 55 but increased over this age, evidence that MS patients are living longer. A similar but more marked increase in MND mortality, and a considerable fall in MS mortality, occurred in the Republic of Ireland. The increase in MND mortality is not due to an increase in the number of neurologists, as there has been little increase in their numbers. The highest MND mortality was in Social Class IIIN males – skilled non-manual

ISSN:0251-5350    

DOI:10.1159/000110936

出版商:S. Karger AG    

年代:1992

数据来源: Karger