摘要:

Brain injury, a leading cause of mortality, morbidity and disability in the United States, has serious consequences and substantial costs. Although previous studies have assessed a variety of outcomes subsequent to brain injury, documentation of performance prior to brain injury using a case-control approach has not been included; preinjury performance differences may confound the estimate of the effects of brain injury on performance. The primary objective of this study was to compare academic performance before and after brain injury in a population of university undergraduate students to determine the extent to which the academic career of the brain-injured person was altered from what would have been expected in the absence of such an injury. Cases included all undergraduate students in a major university, between the ages of 17 and 27, who incurred a brain injury requiring hospitalization between 1980 and 1984 (n = 99). Two comparison groups were used to determine whether changes in academic performance were specifically related to brain injuries or injuries in general: (1) injured controls, i.e. 121 students between the ages of 17 and 27 years, hospitalized for injuries other than to the central nervous system, and (2) uninjured academic controls, i.e. 198 students without injuries requiring hospitalization during the study period, matched 2:1 to the brain-injured students by age, gender, and completed course credits categorized as <90, ≧90. Although there were no differences when the total groups, including both males and females, were compared, there was a significant pre- to postinjury decrease in the grade point average for female cases when compared to their uninjured academic controls (p < 0.02). This difference was related to the effects of brain injury, and not to the effects of injury in general. No such difference was observed for the males. There were also no differences when the total groups, including males and females, were compared relevant to return to school. However, a significantly higher proportion of the female cases, compared with their uninjured academic controls, did not return to school after their injury; similar findings were identified for the injured controls as well. Thus, these differences were not specific to brain injury but rather to injury in general. In spite of this observation, the difference between female cases who returned and those who did not return was associated with neurological deficits, especially upper left limb motor deficits, at the time of hospital discharge. The findings from this effort are suggestive of gender differences in the consequences of brain injury and serve as a basis for further studies to evaluate the magnitude of this proble

ISSN:0251-5350    

DOI:10.1159/000109665

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Background and purpose: The aim of this study was to demonstrate the different results obtained from a population-based and a hospital-based stroke study in the same city. Methods: Between January 1 and December 31, 1993, we collected information on all of the first strokes in the population of the city of Dijon, in conjunction with the Dijon Stroke Registry, collecting the first-ever strokes from patients living in Dijon as well as on all the first strokes in residents and nonresidents of Dijon who were treated at Dijon University Hospital. Demographic details, medical history, vascular risk factors, stroke subtype, as diagnosed by CT scan, and mortality rates were compared between the strokes observed in the population of the city of Dijon among residents as well as nonresidents in Dijon who were treated at Dijon University Hospital. Results: We collected information on 210 strokes observed in the population of Dijon city, 171 Dijon residents and 395 non-Dijon city residents hospitalized at the University Hospital of Dijon. These three groups were quite different. The residents of Dijon treated for stroke at the University Hospital were younger and their incidence of cerebral hemorrhage, cardiac arrhythmia, ischemic heart disease and case fatality rate were higher than those from the Dijon Stroke Registry. Conclusions: Type of stroke data bank is very important in order to describe cerebrovascular disease. Hospital-based studies tend to include more severe strokes, those occurring in a younger population, and those having a higher mortality. Population-based studies, on the other hand, give a somewhat different picture of stroke.

ISSN:0251-5350    

DOI:10.1159/000109666

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We performed a community-based study among children and adolescents with idiopathic and cryptogenic epilepsy and onset of the seizures between 0 and 19 years of age on the prognosis of being seizure-free. The study population was recruited during a descriptive investigation in the Local Health Service of Copparo (USL 34), Ferrara, Northern Italy. We included 111 patients (61 males and 50 females). The average length of follow-up was 18.8 years (ranging from 7 to 24 years). The cumulative probability of being in remission was 81.2% at 15 years after onset and the estimated percentage of patients in remission without therapy was 56 % for the same time period. At 15 years after the onset of epilepsy, approximately 20% of patients continued to have seizures; nearly 25% continued to take antiepileptic drugs but had been free of seizures for at least 5 years; nearly 56% had been without seizures and free of medication for at least 5 years. Seizure type, gender, age at onset of the illness, epileptic abnormalities on EEG, family history of convulsive disorders, number and frequency of seizures prior to the start of treatment were found not to be helpful as prognostic factors. This community study, carried out on patients without the well known factors that adversely affect prognosis, confirms that the prospect of seizure control and for withdrawal of therapy is (generally) good.

ISSN:0251-5350    

DOI:10.1159/000109667

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Detection of subjects with a high risk of developing dementia is a major goal of epidemiological research. Among the potential predictors, minor cognitive impairments detected by psychometric methods could be important precursors. A total of 2,726 elderly nondemented subjects, aged 65 and over, randomly selected from the general population of Gironde (southwestern France) were followed up for 3 years. During this time, 84 developed an incident dementia, diagnosed as Alzheimer''s disease (AD) in 59. The relationships between cognitive performance (Mini Mental State Examination, Benton Visual Retention Test and Isaacs Set Test) measured at the baseline screening of the cohort and the risk of dementia or AD were studied with a discrete Cox proportional hazard model. After adjustment for age and educational level, the three test scores remained strongly related to the risk of dementia or AD. Psychometric performance can be used to screen subjects at risk of developing dementia or AD and allow pharmacological intervention at an early stage.

ISSN:0251-5350    

DOI:10.1159/000109668

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

To study the pattern of stroke in Kuwait, prospective data were collected from all patients admitted with first-ever stroke to our hospital over 3 years: 1989, 1992 and 1993. The primary-care registry over the same period was examined to ascertain that all cases of stroke seen by the primary-care doctors were referred to a hospital. Death certificates issued for people who died outside the hospital were also examined. The study included: clinical evaluation, computed tomography, electrocardiography, blood laboratories, serum chemistry and other investigations as required. The overall annual crude incidence rate was 27.6/100,000 population. The age-adjusted annual crude incidence rate was 145.6/100,000 population. No seasonal variation in the stroke incidence was observed in our study. Carotid-territory large infarction represented 46.5% of all strokes followed by intracerebral haemorrhage in 19.9%, lacunar infarction in 17%, basilar infarction in 8.3% and subarachnoid haemorrhage in 1.7%. The overall case fatality rate was 10%. Mortality increased with age and when loss of consciousness was present. The study demonstrated that stroke incidence in Kuwait is very low due to the young average age of the Kuwaiti population.

ISSN:0251-5350    

DOI:10.1159/000109669

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Background and Purpose: There is increasing evidence that the pathophysiologic mechanisms are different between migraine and tension-type headache. The aim of the study was to determine possible sociodemographic differences in Saudi Arabia subjects with headache. Methodology: A community-based door-to-door survey with identification of headache cases based on IHS criteria. A comparison of sociodemographic variables was made between subjects with migraine and tension-type headache. Results: Headache prevalence was 8% (95% CI = 7.3–8.7%) with a preponderance of tension-type headache (39%). Females were more often affected than males (ratio 2:1). Migraine subjects were more often in the professional occupational group compared with tension-type headache (p < 0.05). Conclusion: Headache prevalence in the community was low. Subjects with migraine and tension-type headache were similar with respect to many demographic variables. Occupational association needs verification in further studie

ISSN:0251-5350    

DOI:10.1159/000109670

出版商:S. Karger AG    

年代:1997

数据来源: Karger