Population-based case-control study of essential tremor

Current epidemiologic data on the association between environmental factors and essential tremor (ET) are scanty. In a population-based case-control study we investigated the relationship between some putative risk factors and ET. In the present study, we included all subjects identified during a door-to-door prevalence survey in a Sicilian community, affected by ET, and alive on 1 November 1987 (n=31). Of the 31 prevalent cases of ET, we were able to contact 28 subjects. Twenty-eight controls were randomly selected from the general population and matched to each case for age and sex. Exposure variables were investigated by interviewing the patients and their controls or close relatives, using a structured questionnaire. The odds for habitual alcohol consumption were 0.3, indicating a protective effect. The odds for exposure to agricultural chemicals and domestic animals were 2.5 and 2.7, respectively, suggesting a role as potential risk factors. However, the associations found by us were not statistically significant.

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Sommario Un argomento poco considerato dalle indagini di epidemiologia analitica riguarda la possibile influenza di fattori di rischio ambientali sull'eziologia del tremore essenziale. Scopo del presente lavoro è quello di verificare l'esistenza di un'associazione tra possibile fattori di rischio e il tremore essenziale, attraverso uno studio caso controllo su popolazione. In un precedente studio di prevalenza di tipo porta a porta, abbiamo identificato tutti i pazienti affetti da tremore essenziale residenti net comune di Terrasini net giorno di prevalenza, 1 Novembre 1987 (n=31). A 28 di tale pazienti e a un gruppo di controloi di uguale numerosità, selezionati dalla popolazione generate e appaiati per età e sesso net rapporto di 1:1, è stato possibile somministrare un questionario strutturato, per valutare l'esposizione a diverse variabili ambientali. Il rischio per it consumo abituale di alcool è risultato di 0,3, suggerendo un effetto protettivo per tale assunzione; al contrario l'esposizione ad anticrittogamici e il contatto abituale con animali domestici hanno mostrato rispettivamente un rischio di 2,5 e 2,7, valori questi the candiderebbero tali esposizioni come fattori the aumentano il rischio di sviluppare it tremore essenziale. Nessuna di tale associazioni è comunque risultata statisticamente significativa.

     

Radiation-induced medulloblastoma in an adult: a functional imaging study

We describe functional imaging findings using MRI, 1H-Magnetic resonance spectroscopy and positron emission tomography in a case of radiation-induced medulloblastoma following radiotherapy for pineal gland tumor. MRS showed a prominent choline peak; FDG, 11C-Met and 11C-Choline PET showed a minimal glucose, increased methionine and choline uptake.     

Population-based pace study: lifetime and past-year prevalence of headache in adults

Primary headache prevalence in the adult Italian general population has been little studied so far. This is an observational, cross-sectional, population-based study conducted in a subject sample that was representative of the city of Parma’s general population ≥age 18. The lifetime prevalence of headache was 69.1%, i.e. 75.8% in women and 60.6% in men; the past-year prevalence of headache was 42.8%, i.e. 52.0% in women and 31.1% in men. Most people suffer from one headache subtype. Headache past-year prevalence decreases with age, both in men and in women. After 60, the likelihood of suffering from headache is low. In more than 80% of cases, headache starts before age 40 and, therefore, it is not very likely for people to develop headache at an advanced age (>50 years). This is the first population-based study conducted in Italy on a sample aged ≥18 since the publication of the IHS diagnostic criteria in 1988.

     

Ultrastructural study of the medulloblastoma in tissue culture

The electron microscopic features of the early phases of growth of the medulloblastoma maintained in vitro are described. The predominant early growth is comprised of small migrating cells with large nucleocytoplasmic ratio, few organelles and prominent neuritic processes containing abundant microtubules. These cells compare favorably with the cells of the primitive external granular layer of the cerebellum and cells cultivated in vitro from the fetal cerebellar cortex previously described. In addition astrocytes containing 70 to 90 A cytoplasmic filaments were commonly found in these cultures. Undifferentiated cells and cells with cilia were present in the explant proper. Cells with processes containing large dense core vesicles were also present in the explant proper suggesting the presence of neuronal differentiation. Our studies support the concept that the medulloblastoma is derived from primitive neuroectodermal cells. In addition it also suggests that astrocytic and neuronal differentiation may occur in this neoplasm in vitro.     

Population-based epidemiological study of primary intracranial tumors in childhood

Object  

Brain tumors are the most common solid tumors in children and their prognosis is poor. Epidemiologic data from a population-based cancer registry provide the information necessary to determine the incidence rate of pediatric brain tumors. The aim of this study was to determine the epidemiology of childhood primary intracranial tumors in Kumamoto Prefecture, Japan.     

Population-based estimates of neuroendovascular procedures: results of a state-wide study

Background: The Brain Attack Coalition identified the availability of neuroendovascular procedures as an essential component of a comprehensive stroke center. Objective: To provide population-based estimates of neuroendovascular procedures. Methods: State-wide estimates of cervicocerebral angiograms, endovascular ischemic stroke treatments, carotid angioplasty and stent placements, intracranial angioplasty and stent placements, endovascular treatment of intracranial aneurysms, and endovascular treatment of intracranial arteriovenous malformations (AVMs) were obtained. We calculated the annual incidence rates of various neuroendovascular and neurosurgical procedures (per 100,000 persons). For the denominator, total persons in each year were categorized in 10-year age intervals. Results: The incidence of carotid endarterectomy (387.6 per 100,000 persons) and carotid stent placement (34.7 per 100,000 persons) peaked at 75-84 years. The incidence of aneurysm embolization also peaked in that population bracket (67.9 per 100,000 persons), yet there was a dramatic reduction in the incidence of surgical aneurysm treatment (3.6 per 100,000 persons) in those aged 75-84 years. There was a prominent reduction in the incidence of all procedures in the population aged ≥85 years, except for intravenous/intra-arterial thrombolytic use in ischemic stroke. The incidence of ischemic stroke increased almost by 50% in the population aged ≥85 years compared to those aged 75-84 years. However, the incidence of endovascular procedures for acute ischemic stroke decreased from 22.8 per 100,000 persons in the population aged 75-84 years to 13.2 per 100,000 persons in the population aged ≥85 years. Conclusions: A marked disproportion of neuroendovascular procedures performed and disease prevalence was noted in persons aged ≥85 years, an increasing segment of the population according to recent Census.     

Population-based studies of childhood disability in developing countries: rationale and study design

Infant mortality level has been used for decades to indicate the health and socioeconomic status of populations. Given the relative availability of necessary data, this indicator has proved most viable. As the more glaring aspects of underdevelopment fade into history in some countries, other health status indices should be considered. Childhood disability is proposed as 1 such indicator. Disability is neither subsumed by nor necessarily correlated with declining infant mortality, and may thus be used to help identify solutions for both short- and longterm problems. To employ this indicator, one needs to know how various types of disabilities are spread through populations as well as the correlated risk factors. Methodology must be developed which is capable of rapidly identifying cases and assessing risk factors. A 2-stage method, comprised of screening and clinical evaluation, is described.     

Generalizability of studies on mental health treatment and outcomes, 1981 to 1996

OBJECTIVE: This study operationalized and measured the external validity, or generalizability, of studies on mental health treatment and outcomes published in four journals between 1981 and 1996. METHOD: MEDLINE was searched for articles on mental health treatment and outcomes that were published in four leading psychiatry and psychology journals between 1981 and 1996. A 156-item instrument was used to assess generalizability of study findings. RESULTS: Of more than 9,000 citations, 414 eligible studies were identified. Inclusion of community sites and patients from racial or ethnic minority groups were documented in only 12 and 25 percent of studies, respectively. Random or systematic sampling methods were rare (3 percent), and 75 percent of studies did not explicitly address sample representativeness. Studies with funding from the National Institute of Mental Health (NIMH) were more likely than those without NIMH funding to document the inclusion of patients from minority groups (30 percent compared with 20 percent). Randomized studies were more likely than nonrandomized studies to document the inclusion of patients from minority groups (28 percent compared with 17 percent), include patients with comorbid psychiatric conditions (31 percent compared with 19 percent), and attend to sample representativeness (28 percent compared with 15 percent). Modest improvements were seen over time in inclusion of patients from minority groups, inclusion of patients with psychiatric comorbidities, and attention to sample representativeness. CONCLUSIONS: Generalizability of studies on treatments and outcomes, whether experimental or observational, remained low and poorly documented over the 16-year period.     

A nationwide epidemiological study of spinal cord injuries in Taiwan from July 1992 to June 1996

Abstract

This prospective epidemiological survey of spinal cord injury (SCI) In Taiwan was carried out by recruiting patients attended by physicians from various medical centers and general hospitals all over Taiwan from july 1992 to june 1996. A total of 6,410 cases of traumatic spirtal fracture were registered among which were 1,586 new cases of SCI. The results represented 70% of the scope of SCI in Taiwan. The observed average annual incidence ofSCI in Taiwan was 18.8 per million population. The mean age was 46. 1 yearsold with a plateau distribution for over 20 years and older. Geriatric victims are a major group of SCI in Taiwan. The male to female ratio was 3 to 1. The leading causes of SCI were traffic accidents and accidental falls. Motorcycle collisions accounted for 62% of the traffic accidents, and as most of the motorcycle riders were not helmet users, head injüry became the major associated injury of SCI in Taiwan. The effectiveness of the comprehensive care system for SCI patients in Taiwan is relatively good, as reflected by the low rates of complications of SCI, the low mortality rate (6.6%), and the high percentage (67.4%) of SCI patients achieving self-care ultimately at home after rehabilitation. The analysis of person days healthy life loss and quality adjusted survival time revealed that SCI patients in Taiwan required 4 years to cope with the morbidity, and on average, could return to the main stream of life for another 30 years. [Neural Res 1997; 19: 617-622]     

Population-based case–control study of morale in Parkinson's disease

Background:  Parkinson's disease (PD) is associated with cognitive, psychiatric, and motor features. Each could contribute to a poor sense of well-being and low morale. A systematic study of morale in community-dwelling PD cases has not been performed.
Methods:  A total of 52 PD cases and 260 matched controls from three Spanish communities were assessed using the Philadelphia Geriatric Center Morale Scale (PGCMS) (range = 0[low morale]–17). The PGCMS includes three dimensions of psychological well-being: agitation, lonely dissatisfaction, and attitude toward own aging.
Results:  The PGCMS score was lower in PD cases than controls (8.71 ± 3.64 vs. 11.03 ± 2.77, P  < 0.001), as were the agitation subscore (3.36 ± 1.91 vs. 4.07 ± 1.59, P  < 0.05), lonely dissatisfaction subscore (3.48 ± 1.36 vs. 4.11 ± 1.12, P  < 0.01), and attitude toward own aging subscore (1.86 ± 1.37 vs. 2.85 ± 1.13, P  < 0.001). In a linear regression analysis that adjusted for depressive symptoms and other covariates, PD cases had a lower PGCMS score than controls ( P  < 0.001).
Conclusions:  Morale was significantly lower in community-dwelling PD cases than matched controls. The detection and possible treatment of this problem may improve the psychological well-being of patients with this disease.     

Update of suicide trends in Italy from 1986 to 1996

Background In some Western countries increasing suicide rates have been observed among males, especially young men, with a decline of female suicides. The present study analysed age-specific and age-standardised suicide rates in Italy. Method From 1986 to 1996 national statistics on numbers of suicides in each sex and age group were examined. Results Overall, suicides have remained substantially stable from 1986 to 1996. Among males over 45 years of age rates progressively decreased, and among subjects below 15 years rates remained stable. In the 15–24 and 25–44 age groups rates progressively rose: an overall increase of 2.76/100,000 and 1.60/100,000 was recorded, respectively. Among females over 45 years of age suicide rates progressively decreased, while rates in the other age groups remained fairly stable. Conclusion The present analysis documents a rise in suicides among young men, and highlights the need for age-specific suicide prevention programmes. Accepted: 11 January 2001