Journal of neurology, neurosurgery, and psychiatry
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Delirium is a common cause of mortality and morbidity in older people in hospital, and indicates severe illness in younger patients. Identification of risk factors, education of professional carers, and a systematic approach to management can improve the outcome of the syndrome. Physicians should be aware that delirium sufferers often have an awareness of their experience, which may be belied by their varying grasp of reality.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Provision of 24 hour acute neurology care by neurologists: manpower requirements in the UK.
The ABN has published standards of care for patients with acute neurological disease. Derriford Hospital provides a 24 hour neurology intake service to a population of 500,000 with the equivalent of four consultants, three specialist registrars (SpRs), and four senior house officers (SHOs) with a 37 bed ward. The authors undertook a prospective study of all neurology admissions to enable calculation of manpower necessary to meet the ABN guidelines. ⋯ Meeting the ABN guidelines will require an increase in total neurology bed provision to at least 15 per 100,000 population, with the equivalent of 3 consultant sessions (11 hours/week). Meeting the European Working Time Directive will require a minimum of 8-10 SpRs working a full shift system, which will have a significant impact on training and other aspects of service delivery.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Comparative StudyBrain metabolic decreases related to the dose of the ApoE e4 allele in Alzheimer's disease.
Declines in brain glucose metabolism have been described early in Alzheimer's disease (AD), and there is evidence that a genetic predisposition to AD contributes to accelerate this process. The epsilon 4 (e4) allele of the apolipoprotein E (ApoE) gene has been implicated as a major risk factor in this process. The aim of this FDG-PET study was to assess the ApoE e4 dose related effect on regional cerebral glucose metabolism (METglc) in clinical AD patients, with statistical voxel based methods. ⋯ The present FDG-PET study showed different metabolic phenotypes related to the ApoE genotype in clinical AD patients, as revealed with voxel based statistical methods. The results suggest a generalised disorder in e4 carriers impairing metabolism globally, in addition to the more localised changes typical of AD patients.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Clinical TrialA short scale for the assessment of motor impairments and disabilities in Parkinson's disease: the SPES/SCOPA.
To evaluate the reliability and validity of the Short Parkinson's Evaluation Scale (SPES)/SCales for Outcomes in Parkinson's disease (SCOPA)-a short scale developed to assess motor function in patients with Parkinson's disease (PD). ⋯ The SPES/SCOPA is a short, reliable, and valid scale that can adequately be used in both research and clinical practice.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Comparative StudyPredicting functional outcome in acute stroke: comparison of a simple six variable model with other predictive systems and informal clinical prediction.
Statistical models that predict functional outcome after stroke using six simple variables (SSV) have recently been developed and validated. ⋯ The SSV models performed as well as or better than other simple predictive systems. These models will be useful in epidemiological studies but should not be used to guide clinical management until their impact on patient care and outcome has been evaluated.