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Biomedical subjects

J S Feigenson

Publications and source records attributed to J S Feigenson.

11 recordsLinked to original sources
PubMed1979

Time-oriented functional profile: practical applications in a stroke data-base model.

The feasibility of transferring data from a large computerized stroke data-base system (BUSTOP) to an existing time-oriented system of proven utility (ARAMIS) is demonstrated. Potential advantages of a time-oriented data-base system include: determination of prognostic indicators, suggestions for therapeutic intervention, analysis of experimental treatment programs, development of units of cost effectiveness and provision for uniform methods of auditing stroke care. This demonstration project shows that a large-scale stroke data-base system is feasible using existing computer models which are currently collecting and analyzing data-base statistics.

Activities of Daily Living↗
PubMed1978

Outcome and cost for stroke patients in academic and community hospitals. Comparison of two groups referred to a regional rehabilitation center.

Patients transferred to a regional stroke rehabilitation center from academic hospital centers (124 patients) and from community hospital centers (315 patients) were compared for outcome and cost of treatment. The two groups were matched for Amended International Classification of Diseases diagnostic category, age, sex, distribution of weakness, types of neurological deficits, time from the onset of the stroke symptoms to admission to the rehabilitation unit, and the concurrence of major medical problems thought to contribute to cerebrovascular disease. There was no statistically significant difference in functional outcome or length of stay, but acute health care costs for patients treated in community hospitals were about 50% less.

Acute Disease↗
PubMed1976

Mental symptoms in Parkinson's disease during chronic treatment with levodopa.

Mental symptoms increased in frequency among 100 patients with parkinsonism treated with levodopa. Dementia was found in about one-third of patients throughout the 6-year treatment period. Thirteen patients became demented during the study, and dementia worsened severely in seven others. Agitated confusion became increasingly frequent and was observed in 60 percent of patients taking levodopa for 6 years. Withdrawal from levodopa decreased agitation, but not dementia. Ten patients received L-tryptophan along with levodopa, but no change in mentation was observed. In view of previous studies of mentation in Parkinson's disease and reports of widespread neuronal changes in the brain of autopsied patients with parkinsonism, our results suggest that the high incidence of dementia in patients with Parkinson's disease who take levodopa reflects prolongation of the course of the illness rather than a direct effect of the medication.

Adult↗
PubMed1976

Piribedil: its synergistic effect in multidrug regimens for parkinsonism.

Piribedil, a dopamine agonist, was administered to 13 patients with long-standing Parkinson's disease whose major symptoms were not well controlled on levodopa, anticholinergics, alpha-methyldopa, amantadine, or a combination of these agents. Twelve of the 13 clearly benefited from the addition of Piribedil although side effects precluded long term use in two cases. Beneficial results were obtained by using a combination of Piribedil, levodopa, and anticholinergic drugs. Side effects (hallucinations, confusion, dyskinesias) were frequent, but were usually reversible by lowering the dosage of levodopa or the accompanying anticholinergic medication. The synergistic effect of Piribedil and other antiparkinsonian drugs emphasizes the need for careful titration of all available medications in difficult cases and demonstrates the usefulness of dopamine receptor stimulators when drugs acting presynaptically have failed.

Aged↗
PubMedDate not supplied

The disability oriented rehabilitation unit--a major factor influencing stroke outcome.

Many investigators have analyzed the effectiveness of the cardiac care unit (as a model of a disability oriented, specially staffed, geographically isolated unit) in altering outcome following acute myocardial infarction. Little data are available, however, on the efficacy of caring for patients with stroke on specially staffed disability oriented units. Of 667 patients with stroke recently discharged from the Burke Rehabilitation Center, 589 were admitted to the stroke unit (SU group) and 78 were admitted to other units (NSU group). Statistical analysis showed that the SU patients were significantly weaker, had longer onset-admission intervals, and exhibited more concurrent medical problems and neurologic deficits. There were no statistically significant intergroup differences in age, sex, and distribution of weakness. Both groups had similar treatment programs provided by staff who had rotated through the stroke unit. Ability to perform activities of daily living (dressing, feeding, hygiene, bowel and bladder routines) and length of hospitalization were similar for both groups. SU patients walked better and went home more frequently than NSU patients. These data indicate than even in a rehabilitation center specializing in treating functional disabilities, patients with stroke are more likely to improve if placed on a disability oriented unit than if they are admitted to mixed disability units which are scattered throughout the hospital.

Activities of Daily Living↗
PubMedDate not supplied

Factors influencing outcome and length of stay in a stroke rehabilitation unit. Part 1. Analysis of 248 unscreened patients--medical and functional prognostic indicators.

A retrospective analysis of 248 patients with stroke (average age 67, range 17-98) admitted to a stroke rehabilitation unit over a sixteen month period showed that 80% of these patients were able to return home after an average length of stay (LOS) of 43 days. At discharge 85% of the group were ambulatory and 56% required no help in daily living activities. Severity of weakness on admission, long onset-admission intervals, the presence of severe perceptual or cognitive dysfunction or a homonymous hemianopsia in addition to a motor deficit were related to unfavorable outcome and increased LOS. The age of the patient, dysphasia or a hemisensory deficit in addition to weakness, or diabetes, hypertension, or ASHD were unrelated to the patients' functional status on discharge, discharge disposition, or LOS. Many patients with "unfavorable prognostic signs" made significant improvement after admission and were subsequently discharges. Thus, while the above findings may predict which patients can make maximal gains in a short term treatment facility, they also show that most patients, even those with "poor prognostic signs," can make enough functional improvement to be managed at home after a relatively short hospitalization.

Activities of Daily Living↗