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PubMedDate not supplied

[Evolution of the demand for ambulatory neurological care and pathologies attended in neurology clinics in the health care district of Tortosa, Tarragona].

AIMS: An analysis was conducted to determine whether there were any changes in the demand for health care, demography and pathologies attended in outpatient departments within the health care district of Tortosa between 1997 and 2003. PATIENTS AND METHODS: Data about the demand for and attendance at first neurology visits over the period 1997 and from March 2003 to February 2004 was collected prospectively. Information concerning age, sex, groups of pathologies, diagnoses, rates of requests for first visits, source of the demand and destination after the visit were compared. RESULTS: Mean age rose from 49 to 56 years (p < 0.001). Patients above 70 years of age increased from 23.7% to 35.9% (p < 0.001), while in the population within the area the figure only rose from 15.8 to 17.1%. The proportion of females went up from 52 to 62% (p < 0.001). Demand (that is, the rate of requests for first visits per 1000 inhabitants per year among those over the age of 15) rose from 8.5 to 9.3, 9.8% (p = 0.03). Demand from primary care increased from 52 to 69% (p < 0.001). Cognitive disorders (6.5% and 15.9%) grew by 144.6% (p < 0.001). Headaches (23.9% and 24.1%), the largest diagnostic group, and non-neurological diagnoses (18% and 18.5%) remained unchanged (p = NS). No changes were observed in the number of discharges in the first visit: 22.8% and 21.1% (p = NS). CONCLUSIONS: The most striking results are the increase in demand (mainly from primary care), the increased age of the population attended and the notable growth in the number of cognitive disorders. These quantitative and qualitative changes in the demand increase the need for resources.

Adolescent↗
PubMed1989

Clinical neurologic assessment tool: development and testing of an instrument to index neurologic status.

The clinical neurologic assessment tool (CNA) is a 21-item instrument assessing response to verbal and tactile stimulation, ability to follow commands, muscle tone, body position, movement, chewing, and yawning in the patient with head trauma. The CNA was developed to detect subtle changes in the patients' neurologic status that may indicate transitions in the comatose state. The CNA has been extensively pilot tested. Reliability determined by using Cronbach's alpha revealed an internal consistency of 0.96. Concurrent validity testing with the Glasgow Coma Scale indicated a strong positive correlation, r = 0.94. Construct validity was assessed with factor analysis using 0.50 for a loading criterion. Three factors were demonstrated: general level of consciousness, muscle tone and resistance, and chewing or yawning. Discriminant function analysis revealed that the CNA scores correctly classified 95.1% of the patient observations into their respective Glasgow Coma Scale categories. The CNA is reliable, valid, convenient, and easily scored and captures the subtle changes in the patient with head trauma.

Adolescent↗
PubMed1982

Neurological differences between paranoid and nonparanoid schizophrenia: part III. neurological soft signs.

A prospective study of 19 neurological soft signs in 44 male chronic schizophrenic patients and 29 matched control subjects revealed significantly more neurological abnormalities in the schizophrenic group. The schizophrenic patients were divided into paranoid and nonparanoid subtypes using the Tsuang-Winokur criteria. No significant differences emerged between the two subtypes.

Adult↗
PubMed1997

[Neurology--a specialty with own criminal novels. Neurological topics in Norwegian criminal literature].

The authors of a large number of Norwegian detective stories, particularly from the first part of this century, are occupied with neurologists and neurobiological problems. A survey of this literature shows. One Norwegian neurologist has written four detective stories. Not one single neurologist can be found as a detective hero. On the other hand there are numerous examples of the neurologist as a criminal or even a murderer. Neurological symptoms and signs (mostly functional pareses and epileptic fits) are used to construct the plot in other novels. The most striking finding is a detective story where the criminal is a neurobiologist, the plot is based on neurobiology and the author discusses neurological phenomena throughout the entire book.

Crime↗
PubMed1993

Swallowing therapy with neurologic patients: results of direct and indirect therapy methods in 66 patients suffering from neurological disorders.

The results of direct and indirect therapy methods applied to 66 patients suffering from neurological disorders are presented. Variables considered were age, time since lesion, localization of central nervous system lesion, type of swallowing disorder (defined according to swallowing phase, type of aspiration and degree of aspiration), cognitive deficits (memory, planning/problem-solving, and attention deficits), and duration of therapy. Success of therapy was defined by progress in type, ease, and safety of feeding and by range of diet. Therapeutic outcome was correlated with the above-listed variables. The findings suggest that swallowing therapy is effective for patients with neurological disorders.

Adult↗
PubMed2006

[Neurological Reha-Score. An instrument to measure outcome and expenditure of neurologic rehabilitation].

BACKGROUND: A new measurement instrument was developed to combine common scores with the parameter of effort for rehabilitation, the latter being a control instrument for medical professionals and rehabilitational health organisations. METHODS: The Neurological Rehabilitation Score (NRS) contains 61 items (including the ten from the Barthel Index) resulting in scores of 0 (worst patient condition) to 600 (best). The items are grouped into seven categories: activities of daily life (13), mobility (8), communication and social skills (7), arm and hand function (7), orientation and cognition skills (10), strength and pain (8), and coping and miscellaneous (8). We investigated 8,139 patients and determined reliability (kappa statistic) and responsivity (standardised response means). In 100 consecutive patients, we also measured the Functional Independence Measure (FIM) and Scandinavian Stroke Scale (SSS) to address validity. RESULTS: With an average kappa value of 0.86 (range 0.62-0.98), the NRS showed excellent inter-rater reliability. There was a good correlation between NRS, FIM, and SSS. Response was good at 0.84. The ceiling effect was also less than 1%, compared to 17% in the Barthel Index. CONCLUSION: The NRS was shown to be effective for evaluation of outcome and expenditure in neurological rehabilitation.

Activities of Daily Living↗
PubMed1989

Examination of eight cases of multiple sclerosis and 56 neurological and non-neurological controls for genomic sequences of measles virus, canine distemper virus, simian virus 5 and rubella virus.

In situ hybridization studies have been carried out on brain samples from eight cases of multiple sclerosis (MS) and 56 non-neurological and neurological controls, using single-stranded 35S-labelled RNA probes prepared against genomic RNA sequences of measles virus, canine distemper virus, rubella virus and simian virus 5. Foci of hybridization were found using probes against the measles virus nucleocapsid protein (N), phosphoprotein and fusion protein gene sequences in two of the MS cases, and also in one control, a case of disseminated cytomegalovirus infection with spinal cord necrosis. This result was confirmed using biotinylated probes prepared against the measles virus N genomic sequence. No hybridization was found in any of the MS or control cases using any of the other viral genome-specific probes.

Astrocytoma↗
PubMed1998

Differences in neuropsychological functioning associated with age, education, neurological status, and magnetic resonance imaging findings in neurologically healthy elderly individuals.

In a cross-sectional study, a sample of 113 individuals, 55 to 85 years old, without any neurological diseases was investigated. The study provides information on differences associated with age, education, and gender, and in relation to neurological status, magnetic resonance imaging, and cognitive functioning. Differences between age groups were shown in memory, constructional, and language functions, and especially in tests related to speed and attention. Education was related to most of the cognitive functions, but especially to verbal intellectual functions, visual and logical memory, language functions, and calculation. Gender differences were found in finger tapping, constructional functions, and verbal intellectual functions. Primitive reflexes showed a tendency to correlate with comprehension and memory of sentences. Extrapyramidal signs were related to psychomotor speed, and attention, verbal fluency, and set shifting together with intellectual functions and learning. Central atrophy on magnetic resonance imaging was related to memory functions in those 65 and 70 years of age, whereas in the oldest age groups immediate recall was associated with the severity of lesions.

Journal Article↗
PubMed2005

[Treatment of Alzheimer's disease: recommendations and suggestions of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology].

The present recommendations and suggestions on "Treatment of Alzheimer's Disease" were elaborated by a work group constituted by participants of the IV Meeting of Researchers on Alzheimer's Disease and Related Disorders, sponsored by the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. They comprise topics on pharmacological and non-pharmacological treatment of cognitive impairment and functional decline, as well as of behavioral and psychological symptoms of this dementing disease. Several levels of evidence and of recommendations and suggestions are used for the various proposed drugs, as well as for non-pharmacological treatment, underpinned by a wide national and international bibliographical review.

Academic Medical Centers↗
PubMed2005

Prizes, lectures, and awards of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Tumors.

An important goal of the Section on Tumors of the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) since its founding in 1985 has been to foster both education and research in the field of brain tumor treatment. As one means of achieving this, the Section awards a number of prizes, research grants, and named lectures at the annual meetings of the AANS and CNS. After a brief examination of similar honors that were given in recognition of pioneering work by Knapp, Cushing, and other early brain tumor researchers, the authors describe the various awards given by the AANS/CNS Section on Tumors since its founding, their philanthropic donors, and the recipients of the awards. The subsequent career of the recipients is briefly examined, in terms of the rate of full publication of award-winning abstracts and achievement of grant funding by awardees.

Awards and Prizes↗
PubMed2004

What we research: survey of American Association of Neurological Surgeons and Congress of Neurological Surgeons member publications.

OBJECT: The goal of this study was to create a searchable database of research manuscripts authored by members of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons (AANS/CNS) to describe the nature and character of the research currently being undertaken by neurosurgeons. METHODS: Manuscripts published by all physician members listed in the 2001 AANS/CNS Membership Directory (6921 physicians) were gathered into a database through individual literature searches of the author name for the calendar year 2001. Duplicate publications were purged and the database was reviewed for accuracy. An internal verification of the database revealed a 4% underreporting rate. Statistics from the database were compiled and displayed with information about AANS/CNS members and their clinical activities. The AANS/CNS members published a total of 2748 research the manuscripts in 479 different journals during 2001. Thirty-eight percent of the manuscripts (1042 of 2748) were authored by US members and 62% (1706 of 2748) by non-US members. The focus of the majority of manuscripts included the areas of brain tumor (26%; 707 of 2748), vascular disease (20%; 558 of 2748), spine (10%; 282 of 2748), and trauma (8%; 233 of 2748). Sixty-nine percent of manuscripts (1897 of 2748) were retrospective and technical clinical studies, and of these 39% (744 of 1897) were case reports. Laboratory investigations made up 15% (414 of 2748) of all manuscripts, whereas prospective randomized clinical trials represented 1% (34 of 2748). CONCLUSIONS: The majority of AANS/CNS member manuscripts are authored by non-US members despite their small AANS/CNS representation. Most research is clinical, based on retrospective data, and includes a large number of case reports. A disparity exists between what neurosurgeons do clinically and both the quantity and subject of their research.

Authorship↗
PubMed2001

Neurological disability and neurological rehabilitation.

Evidence is increasing that neurorehabilitation lessens patient disability and improves quality of life in both acute and chronic neurological conditions. A focused, multidisciplinary team approach is the key to a successful rehabilitation outcome. The general practitioner will be more closely involved in the rehabilitation process in the future. Patients will be discharged home earlier to complete the acute rehabilitation program. GPs will supervise function over the long term and activate community rehabilitation resources when necessary to maintain patient function. Ideally, rehabilitation services should be available for most patients with neurological disorders, as it is difficult to predict which individual patients will not benefit.

Activities of Daily Living↗
PubMed2000

Neurologic recovery and neurologic decline after spinal cord injury.

Physicians caring for patients with spinal cord injury facilitate neurologic recovery by optimizing nutrition and general health, by coordinating active exercise and functional training to enhance the underlying synapse growth, reversal of muscle atrophy, and motor learning, and by controlling interfering spasticity. SCI physicians also must monitor for neurologic decline during initial rehabilitation and later in life, diagnose promptly and accurately such decline, and orchestrate the appropriate intervention.

Humans↗
PubMed2000

Program requirements for residency/fellowship education in neuroendovascular surgery/interventional neuroradiology: special report on graduate medical education: a joint statement by the American Society of Interventional and Therapeutic Neuroradiology, Congress of Neurological Surgeons and American Association of Neurological Surgeons, American Society of Neuroradiology.

Neuroendovascular surgery/interventional neuroradiology is a relatively new subspecialty that has been evolving since the mid-1970s. During the last 2 decades, significant advances have been made in this field of minimally invasive therapy for the treatment of intracranial cerebral aneurysms; acute stroke therapy intervention; cerebral arteriovenous malformations; carotid-cavernous sinus fistulae; head, neck, and spinal cord vascular lesions; and other complex cerebrovascular diseases. Advanced postresidency fellowship programs have now been established in North America, Europe, and Japan, specifically for training in this new subspecialty. During a period of 14 years, from 1986 to the present, an ad hoc committee comprising senior executive committee members of the American Society of Interventional and Therapeutic Neuroradiology, the Joint Section of Cerebrovascular Neurosurgery, and the American Society of Neuroradiology met to establish general guidelines that were mutually agreeable to both societies for training physicians in this field. These training standard guidelines were unanimously endorsed by the Executive Committee of the Joint Section of Cerebrovascular Neurosurgery in April 1999, by the Executive Committee of the American Society of Interventional and Therapeutic Neuroradiology and the American Society of Neuroradiology in May 1999, and by the Executive Council of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons in June 1999. The guidelines for residency/ fellowship education have now been endorsed by the parent organizations of both the interventional and diagnostic neuroradiology communities, as well as both senior organizations representing neurosurgery in North America. These guidelines for training should be used as a reference and guide by any institution establishing a training program in neuroendovascular surgery/interventional neuroradiology.

Curriculum↗
PubMed1992

[The pattern of neurological deterioration and the mechanism of neurological deficit in syringomyelia].

Sixty-five cases of syringomyelia were evaluated. The cases were classified into two groups: group 1 (56 cases) was patients who presented with hind-brain related syringomyelia and group 2 (9 cases) was patients who presented with primary spinal syringomyelia. Group 1 was further divided into two subgroups, group 1a and group 1b: group 1a (46 cases) consisted of patients with hind-brain related syringomyelia without basal arachnoiditis and group 1b (10 cases) consisted of patients with hind-brain related syringomyelia with basal arachnoiditis. The most common initial symptom of group 1a patients was abnormal motor function of an upper limb (14 cases), followed by pain in an upper limb (12 cases), and dissociated sensory loss (10 cases). In group 1b, motor symptoms of an upper limb were also the most common initial symptom, again followed by pain in an upper limb. Paraplegia was the most common initial symptom in group 2. About 80% of patients in groups 1a and 1b had both sensory and motor deficits at the time of examination and the majority of group 1b patients also had brain stem signs and/or pain. Brain stem signs were not commonly seen in group 1a patients, however. The neurologic deficits of group 1b patients were generally more severe than those of group 1a patients. Most group 2 patients also had sensory and motor deficits of both lower limbs. The progression of neurological deficits in groups 1a and 1b was classified into four stages.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2003

[Neurological complication due to the drug and the maneuver for the treatment and prevention of cerebrovascular diseases: iatrogenic neurology].

Neurological sequela which occur with the medication and procedure to treat or prevent cerebrovascular diseases are reviewed. The report by the NINDS upon the recombinant tissue plasminogen activator (rt-PA) for cerebral infarction showed overall improved prognosis and increased number of cerebral hemorrhage from 1 to 9. Individual approach rather than statistical analysis should be applied to the adverse effect of the treatment. The rhabdomyolysis by statin, the HMG-CoA reductase inhibitor, is well known. The frequency of elevation in serum creatine kinase activity increases from water-soluble statin to lipid-soluble statin and to statin of longer half-life and with entero-hepatic recirculation. All of the interventional procedure such as embolization, stent, intravascular thrombolysis, endarterectomy and EC-IC bypass are possibly complicated by bleeding, arterial occlusion, distal embolism and so on. Guidelines are also a possible source of iatrogenic diseases. For example, 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension recommend at least 3 months of non-pharmacological treatment before starting the anti-hypertensive medications. The possibility to develop stroke within 3 months after the initial examination, however, is not zero. This is what can be called as guideline-induced neurological disease, of which practical physician should be reminded.

Cerebral Hemorrhage↗
PubMed1989

[Ambulatory neurological care outside of the hospital. Analysis of the demand registered during 18 months in a neurological outpatient clinic].

The major data from the care demand in a neurological outpatient clinic in the south area of Madrid are reported. 8.9 patients per 1,000 inhabitants are seen. The frequency of visits to this clinic is higher in females and with advancing age. More than one-half of the patients are diagnosed as having conditions not necessarily representing organic neurological disease. It is concluded that a better selection of the patients referred to this clinic should be adequate, as the number of neurologists per 100,000 inhabitants available in this country is not sufficient to care for so high an outpatient care demand.

Adolescent↗
PubMed1986

Ten-year consistency in neurological test performance of children without focal neurological deficit.

To assess 'soft-sign' persistence and its correlates outside a referred sample, 159 members of a local birth cohort of the United National Collaborative Perinatal Project were traced and their performance on six neurological test scales was measured at age 17 by examiners blind to their status at age seven. A comparison group was also formed, who had been 'sign-free' at age seven. On four of the six tests (dysdiadochokinesis, mirror movements, dysgraphesthesia and motor slowness) index boys did significantly worse than the comparison boys; by contrast, index girls scored significantly worse than comparisons only on motor slowness.

Adolescent↗