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  • 1
    Electronic Resource
    Electronic Resource
    Assessment of International Headache Society diagnostic criteria: a reliability study (1994)
    USA/Oxford, UK : Blackwell Science Ltd
    Cephalalgia 14 (1994), S. 0 
    Details
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In 1988 the International Headache Society (IHS) introduced new diagnostic criteria for headaches and craniofacial pain. Since headaches can be diagnosed solely on the basis of information provided by the patient, it is essential that the criteria are reproducible and consistent. Two neurologists evaluated the clinical records of 100 consecutive outpatients and transferred the data on headache and associated phenomena to a form designed to reflect the IHS criteria. Interobserver concordance (kappa statistics) in the application of the diagnostic criteria of primary headaches was: (i) “perfect” to “substantial” for the first IHS digit, being kappa = 1.0 for cluster headache and paroxysmal hemicrania; kappa = 0.88 for migraine; kappa = 0.75 for tension-type headache; (ii) “almost perfect” to “substantial” for the second digit (kappa = 0.94 for cluster headache; kappa = 0.90 for migraine with aura; kappa = 0.81 for episodic tension-type headache; kappa = 0.78 for migraine without aura; kappa = 0.71 for chronic tension-type headache; kappa = 0.66 for cluster headache-like disorder not fulfilling the criteria; (iii) “moderate” for migrainous disorder (kappa = 0.48) and headache of the tension-type (kappa = 0.43) not fulfilling the criteria. These results show that the IHS diagnostic criteria are satisfactorily applicable to high quality medical records abstracted by experienced neurologists.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1468-2982.1994.1404280.x
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  • 2
    Electronic Resource
    Electronic Resource
    Survival in multiple system atrophy: a study of prognostic factors in 59 cases (1996)
    Springer
    Journal of neurology 243 (1996), S. 401-404 
    Details
    ISSN: 1432-1459
    Keywords: Multiple system atrophy ; Olivopontocerebellar atrophy ; Striatonigral degeneration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The various clinical features of multiple system atrophy (MSA) make the diagnosis of the disease difficult, especially in its early stages, when signs of differentiated neuroanatomical system involvement have not yet appeared. Mortality studies may be affected by the variability of the diagnostic criteria and selection bias. We used strict clinical and MRI criteria to diagnose MSA in 59 patients. Patients with parkinsonian and cerebellar onset were compared. Median survival time from the onset of the first motor symptom was 7.5 years. Our results indicated a trend (P = 0.09) for the Northwestern University Disability Scale score to correlate with mortality, but we failed to find other characteristics identifying subgroups or predictors for survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00868999
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  • 3
    Electronic Resource
    Electronic Resource
    Advantage of treating anaplastic gliomas with aggressive protocol combining chemotherapy and radiotherapy (1997)
    Springer
    Journal of neuro-oncology 34 (1997), S. 179-185 
    Details
    ISSN: 1573-7373
    Keywords: anaplastic gliomas ; chemotherapy ; prognostic factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We devised a treatment protocol for anaplastic gliomasconsisting of: (a) chemotherapy prior to radiotherapy (b)a second chemotherapy regimen at tumor recurrence (c)repeated surgery whenever possible. 41 Anaplastic Astrocytoma (AA),16 Anaplastic oligoastrocytoma (AOA) and 14 anaplastic oligodendroglioma(AOD) patients were treated. After surgery all patientsreceived 5–6 cycles of carmustine + Cisplatinum chemotherapy.Radiotherapy was started during the last 2–3 cyclesof chemotherapy. 17 patients (30.5%) were reoperated-on atrecurrence. All recurring patients underwent PVC chemotherapy. Atthis moment disease recurred in 56 patients. MedianTTP was 24.5, 38.7 and 58.2 months forAA, AOA and AOD respectively. Median ST was38.8, 71.8 and 73 months. In conclusion oursandwich protocol of prior chemotherapy, overlapping irradiation withsecond chemotherapy and, in favourable cases, a secondsurgical intervention, is of benefit in patients withanaplastic gliomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005705624858
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  • 4
    Electronic Resource
    Electronic Resource
    Parental occupation, occupational exposure to solvents and polycyclic aromatic hydrocarbons and risk of childhood brain tumors (Italy, France, Spain) (1997)
    Springer
    Cancer causes & control 8 (1997), S. 688-697 
    Details
    ISSN: 1573-7225
    Keywords: Brain neoplasms ; child ; Europe ; parental occupation ; polycyclic aromatic hydrocarbons ; solvents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The role of parental occupational exposure in childhood brain tumorswas investigated in a population-based case-control study grouping 251 casesand 601 controls from three European centers: Milan (Italy), Paris (France),and Valencia (Spain). Parental occupational exposure to solvents andpolycyclic aromatic hydrocarbons (PAH) during the five-year period beforebirth was estimated using a job-exposure matrix developed earlier in the samecountries. Odds ratios (OR) of brain tumors for each occupation andoccupational exposure were estimated by logistic regression, adjusting forchild’s age, gender, exposure to tobacco smoke and ionizing radiation,mother’s age and years of schooling, and center. The risk of childhood braintumors rose when fathers worked in agriculture (OR = 2.2, 95 percentconfidence interval [CI] = 1.0-4.7) and motor-vehicle-related occupations. Inthe latter group, the risk increased for primitive neuroectodermal tumors inparticular (OR = 2.7, CI = 1.1-6. 6). Astroglial tumors were more frequentamong children of mothers in health services (OR = 2.2, CI = 1.0-4.9).Paternal exposure to PAHs was associated with an increased, but notdose-related, risk of primitive neuroectodermal tumors (OR = 2.0, CI =1.0-4.0), and maternal exposure to solvents at a high level was associatedwith an increased risk of both astroglial (OR = 2.3, CI = 0.9-5.8) andprimitive neuroectodermal tumors (OR = 3.2, CI = 1.0-10.3).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1018419118841
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  • 5
    Electronic Resource
    Electronic Resource
    Relation of cognitive impairment and depression to quality of life in multiple sclerosis patients (1998)
    Springer
    Neurological sciences 19 (1998), S. S392 
    Details
    ISSN: 1590-3478
    Keywords: Quality of life ; Multiple sclerosis ; Outcome measures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Abbiamo stimato il contributo dei disturbi cognitivi e timici nel determinare la qualità di vita associata allo stato di salute (QDVAS) dei pazienti con sclerosi multipla (SM), la validità della QDVAS riportata dai pazienti con deficit cognitivo, e Faccuratezza della stima di QDVAS del paziente effettuata da parte della persona a lui vicina. Erano considerati eleggibili i pazienti con SM ambulatoriali ed ospedalizzati afferiti nel periodo aprile–settembre 1997 presso i tre centri partecipanti. Il neurologo curante illustrava al paziente FMS quality of life 54 (MSQOI -54) e, se necessario, lo assisteva nella compilazione. Una versione proxy dell'MSQOL-54 era completata indipendentemente da parte dalla persona the il paziente considerava a lui più vicina. I 204 pazienti avevano un' età media di 43 anni ed un punteggio medio di 4.5 all'expanded disability status scale (EDSS). I pazienti cognitivamente compromessi hanno presentato difficoltà nella compilazione del questionario ed hanno fornito un elevato numero di risposte mancanti o incoerenti. I principali determinanti della QDVAS sono risultati la presenza di sintomi depressivi e l' età del paziente. Il grado di accordo try la QDVAS riportata dal paziente e dal proxy era moderato o sostanziale per gran parte delle scale, con una generale tendenza da parte del proxy a sottostimare la QDVAS. Nonostante il paziente sia la fonte più appropriata per la stima della sua QDVAS, l'impiego di informazioni ottenute da un proxy è da preferirsi in presenza di deterioramento mentale.
    Notes: Abstract The objectives of the present study were to determine the role of cognitive and mood disorders as determinants of health-related quality of life (HRQOL) in multiple sclerosis (MS), as well as to evaluate the validity of self-assessed HRQOL in cognitively impaired patients and the agreement between self-assessed and proxy-reported HRQOL. The study included 204 MS inpatients and outpatients seen between April and September 1997 at three participating centers. The MS quality of life 54 (MSQOL-54) was explained to the patients by a neurologist who also assisted them to complete the questionnaire. A proxy version of the MSQOL-54 was completed independently by each patient's designated proxy. The mean age of the patients was 43 years; the mean expanded disability status scale (EDSS) score was 4.5. Cognitively compromised patients had considerable difficulties in completing the questionnaire, and gave a high percentage of missing and inconsistent items. Depressive symptoms and age had the most important influence on patients' HRQOL. The level of agreement between self-assessed and proxy-reported HRQOL was moderate to substantial for most scales, with proxy informants rating patients as slightly more impaired. Although the patient should be the best informant concerning HRQOL, information from a proxy respondent may be preferable in patients with severe cognitive impairment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00539594
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