ISSN:0251-5350    

DOI:10.1159/000110351

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Multiple sclerosis (MS) prevalence rates were examined for the fiscal years 1984/1985–1988/1989, in the province of Alberta, Canada, by age, sex and census division. Data were derived from the health care records of individuals registered with the Alberta Health Care Insurance Plan which requires registration by all residents of the province (approximately 2.4 million). The overall crude prevalence rate was 216.7 per 100,000 (173.1 for males; 260.3 for females) population. Females had a significantly higher prevalence (p < 0.05) and the rates were highly correlated between the sexes (r = 0.94, p < 0.01). The present study confirms other studies finding a high prevalence rate within the province of Alberta. The prevalence rate for Alberta is among the highest reported in the world indicating that the province appears to be an excess risk area relative to other global locations. Also, the results indicate that MS is unevenly distributed throughout the province which offers support for the involvement of environmental factors related to the onset of this disorde

ISSN:0251-5350    

DOI:10.1159/000110352

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Prevalence of multiple sclerosis (MS) was determined in the Canton of Berne, Switzerland. This canton is a geographically diverse region at 47° northern latitude with 920,000 inhabitants. Epidemiological data were obtained from the case records of the University Department of Neurology, from the Swiss MS Society, from practicing neurologists and from regional hospitals. Diagnostic accuracy was ascertained in retrospect, and only those cases fulfilling the criteria proposed by the Poser Committee were included. Of the patients provided by the Swiss MS Society, only those who had been diagnosed by a neurologist were accepted as definite cases. Changes of population due to migration or death were traced at governmental registry offices, and the place of residence was determined. Using the 1,016 cases of definite and probable MS identified, the minimal prevalence rate was 110 MS cases/ 100,000 inhabitants in the Canton of Berne on January 1, 1986. The increase in MS in this region since the 1950s was due mainly to the increase in life duration of MS patients rather than an increase in incidence rates over the last 20 years

ISSN:0251-5350    

DOI:10.1159/000110353

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Stroke recurrence has been investigated primarily with respect to prognostic factors predictive of recurrence. Several parametric functions are considered in modeling the distribution of ischemic stroke recurrences recorded within the Stroke Data Bank. A linear hazard function is shown to be the best-fitting function among those considered. This method of parametric modeling may lead to a more informed approach to treatment of ischemic stroke and secondary prevention and may enhance future investigations of prognostic factors as well.

ISSN:0251-5350    

DOI:10.1159/000110354

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We evaluated the age-related stroke risk factors in 164 Italian male patients with a diagnosis of first-ever ischemic stroke. Based on the age, we divided the patients into two groups: 42 patients ranging in age from 40 to 55 years, and 122 patients ranging in age from 56 to 75 years. For each case, an age-matched control without a history or symptoms indicating vascular disease was randomly selected from hospital patients. Information were obtained on the various risk factors. Univariate analysis showed that for the younger patients high systolic blood pressure, diabetes mellitus, hypertriglyceridemia, smoking and family history of ischemic stroke were significantly related to stroke. In the older patients, high diastolic blood pressure and smoking had a strong association with stroke. Multivariate analysis showed that high systolic blood pressure, hypertriglyceridemia, smoking and family history of stroke remained significantly and independently associated with stroke in patients up to the age of 55 years. Among patients 56 years or older, only high systolic and diastolic blood pressure, and smoking were significant predictors of stroke. In conclusion, the sets of factors associated with the risk of stroke among young and old male patients appear to be different.

ISSN:0251-5350    

DOI:10.1159/000110355

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A door-to-door survey of transient ischemic attack (TIA) and stroke was conducted in 3 towns of the Alcoi health area. The prevalence ratios found for TIA and stroke were 13/1,000 people (95% CI 8.8–17.9) and 21.5/1,000 (95% CI 15.8–27.2), respectively. The crude incidence rates for both TIA and stroke were 2.8/1,000 (95% CI 0.7–4.9). Methodological differences in the ascertainment of the cases may explain the variations in the rates between the present work and other studies in the liter

ISSN:0251-5350    

DOI:10.1159/000110356

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We have developed a protocol to identify unnecessary days of hospitalisation in the Department of Neurology of the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Seventy-four parameters (medical, social, type of investigation and treatment, degree of disability and of dependence) potentially associated with the length of stay were studied prospectively in 511 nonselected patients consecutively admitted to the Department over a period of 5 months. Each day spent on the wards was analyzed on a day-to-day basis and was classified into one of two groups: those due to a medical reason (4,700 hospital days), and those due to a nonmedical reason (1,184 days). These delays resulted chiefly from difficulties in obtaining laboratory investigations, especially in patients who were not disabled and who had been admitted for investigations (3.8% of hospital days, compared to 1.5% for patients with severe or total dependence) or from awaiting transfer to either another department or a nursing home. This second cause of delay markedly increased the length of stay of patients with severe or total dependence and with limited mobility on the first day (26.0 days, compared with 7.4 days for nondisabled patients) and, above all, on the last day spent in our Department (27.0 days, compared with 8.0 days). The ongoing analysis of these data may provide information as to which parameters could be influenced by neurologists in order to reduce the length of stay in hospital.

ISSN:0251-5350    

DOI:10.1159/000110357

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The prevalence of cognitive impairment was determined in a random age- and sex-stratified sample of 2,011 elderly Hong Kong Chinese, aged 70 years and over, consisting of subjects living in the community and in institutions. The Information/ Orientation Section of the Clifton Assessment Procedure was used as the screening instrument using a cutoff point of 7. The overall age-adjusted prevalence was 5% for men and 22% for women, and 15% for both sexes combined. Univariate analysis identified the following associated factors in order of magnitude of the odds ratio: age; history of Parkinson''s disease; functional disability; female sex; low educational level; low social class; history of stroke, and low monthly income. Other diseases, such as heart disease, hypertension, chronic lung diseases or diabetes, were not associated factors. In multivariate analysis, all the above factors remained significant with the exception of a history of stroke. The prevalence figures are comparable to other Caucasian and Chinese studies, and the associated factors identified suggest that there may be room for prevention.

ISSN:0251-5350    

DOI:10.1159/000110358

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We compared the sensitivity and specificity of recently proposed general dementia, vascular dementia, and Alzheimer''s disease criteria using the DSM III-R as the ''gold standard'' among 61 elderly African American patients. There were 10 patients with vascular dementia, 20 with Alzheimer''s disease and 31 controls. Comparison of the sensitivity and specificity of the various criteria showed that with few exceptions, the results were similar. Additional studies of this kind among different populations, and among mild dementia patients, are needed to cross-validate the results.

ISSN:0251-5350    

DOI:10.1159/000110359

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In order to test the value of Hodkinson''s test (HT) for the detection of dementia and other milder forms of cognitive impairment in community surveys, we have studied two separate groups of 50 individuals; one of the groups included individuals with dementia or mild cognitive impairment (MCI), and the other individuals with no cognitive disturbances. Both groups were drawn from the same rural population and subjected to HT and a neuropsychological exam for positive and differential diagnosis of cognitive impairment. The gold standard criteria for the diagnosis of dementia and MCI were the DSM-IIIR criteria and a simplified and adapted version of the criteria established for age-associated memory impairment. We found that the best cutoff of HT providing maximum sensitivity and specificity for the diagnosis of both dementia and MCI was 7. For this cutoff, sensitivity and specificity for the diagnosis of MCI were 94 and 90%, respectively; for the diagnosis of dementia sensitivity and specificity were 100 and 53%, respectively. This together with its brevity, low cost and independence of sensory impairment and cultural background makes the HT useful for large population-based screening of dementia and MCI.

ISSN:0251-5350    

DOI:10.1159/000110360

出版商:S. Karger AG    

年代:1994

数据来源: Karger