1,721,141 research outputs found
Incidence and short-term prognosis of status epilepticus in adults in Bologna, Italy
No full textPurpose: To determine the incidence and the 30-day case fatality of status epilepticus (SE) in the adult resident population of the city of Bologna, Italy. Methods: Over a 1-year period (March 1, 1999 to February 29, 2000), all patients older than 20 years with SE were included. The case-finding method was based on (a) a prospective surveillance of all public general hospitals in the city by neurologic units, and (b) a review of all discharge codes concerning epilepsy. Results: The crude and standardized annual incidence rate of SE was 13.1 per 100,000 [95% confidence interval (CI), 9.5-17.5] and 10.7 (95% CI, 7.5-13.8). It was higher in the elderly (older than 60 years) than in young adults (26.2 vs. 5.2) and in women than in men (14.9 vs. 11.0). Acute symptomatic SE accounted for 48%, and a cerebrovascular pathology was the most frequently associated etiologic condition (41%). A history of seizures was reported in 39% of patients. The 30-day case fatality was 39% (33% excluding postanoxic patients). Conclusions: This study reports the first data on the epidemiology of SE in Italy. The incidence rate found in the population of Bologna is in the same range as that of the other European countries. The 30-day case fatality is higher than all the other population studies (both European and American), despite the broadly similar clinical features of patients. Indirect evidence suggests that some inaccurate patient management could have negatively influenced the outcome of SE
A 5-year prospective cohort study on health-related quality of life in patients with narcolepsy.
No full textOBJECTIVE: To evaluate the 5-year variation of health-related quality of life (HRQoL) and mood symptoms in a cohort of patients with narcolepsy.
METHODS: Adults attending the Sleep Centre of the Department of Neurological Sciences, University of Bologna in 1997 and meeting the International Classification of Sleep Disorders-Revised criteria for the diagnosis of narcolepsy were eligible. Included patients self-administered the Medical Outcome Short Form-36 (SF-36) and the Zung depression scale (ZDS) prospectively in 1998 and 2003.
RESULTS: There was no significant difference between 1998 and 2003 measures of SF-36 and ZDS in the 54 patients included. About 25% of them showed moderate or severe mood symptoms in both observations. ZDS score (inversely) and duration of disease (directly) explained a percentage of variance of role physical, vitality (VT), social functioning (SF) and role emotional. At the second observation VT and SF had a further percentage of variance explained by excessive daytime sleepiness (EDS) and age at onset. Self-reported diabetes frequency doubled after 5 years (from 7% to 17%).
CONCLUSIONS: Patients with narcolepsy show a stable impairment of HRQoL in a 5-year period with respect to Italian normative data. Mood status and EDS negatively influence their HRQoL while disease duration has a positive influence
L'analisi dell'accordo fra osservatori e delle fonti di variabilità come strumento per il miglioramento della qualità in medicina legale
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A case of occipital epilepsy in an elderly woman
No full textA 73-year-old woman experienced stereotype episodes of complex visual hallucinations over five months. Initially, they were rare and consisted of pleasant static pictures emerging from the left visual field, usually lasting 5 to 10 seconds. Subsequently, they became moving, tormenting pictures, recurring several times a day. On admission, neurological examination revealed reduced contact, nystagmus with fast phase to the left and a left homonymous hemianopia. Electroencephalography (EEG) demonstrated recurrent epileptic discharges starting from the right occipital lobe. The EEG showed sporadic occipital epileptiform activity during the attack-free periods. Phenytoin therapy stopped the seizures and normalized the EEG. An ischemic lesion in the right occipital lobe was detected on cerebral magnetic resonance imaging (MRI) with gadolinium. She continued antiepileptic treatment without recurrence of seizures in the following nine months. This observation of vascular damage-related occipital seizures indicates that epilepsy may be the cause of misdiagnosed behavioral and cognitive disturbances in the elderly. Its prompt recognition is important, since treatment may resolve this type of disorder
Interrater reliability as quantitative end-point for legal medicine in work ability assessment: a lesson from an epidemiological study applied to a neurological disease
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Sex disparities in clinical features and burden of narcolepsy type 1
Full text linkTo investigate potential sex-related differences in patients with narcolepsy type 1, we carried out an analysis of baseline data from 93 women and 89 men with narcolepsy type 1 who participated in the TElemedicine for NARcolepsy (TENAR) trial. The following data were considered: sociodemographics; diagnostic (disease history, polysomnography, orexin, human leukocyte antigen) and clinical features, including sleepiness (Epworth Sleepiness Scale), cataplexy and other narcolepsy symptoms; disease severity (Narcolepsy Severity Scale); pharmacological treatment; depressive symptoms (Beck Depression Inventory); and self-reported relevance of eight narcolepsy-related issues. We found that, compared with men, significantly more women reported automatic behaviours (55.4% versus 40%) and had higher Epworth Sleepiness Scale (median 10 versus 9) and Beck Depression Inventory scores (median 10.5 versus 5), and there was a trend for a higher Narcolepsy Severity Scale total score in women (median 19 versus 18, p = 0.057). More women than men were officially recognized as having a disability (38% versus 22.5%) and considered 5/8 narcolepsy-related issues investigated as a relevant problem. More severe sleepiness and a greater narcolepsy-related burden in women could mirror sex differences present in the general population, or may be related to suboptimal management of narcolepsy type 1 or to more severe depressive symptoms in women. Future studies and guidelines should address these aspects
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