Neuroepidemiology
-
We performed a case-control study on the use of cellular and cordless telephones and the risk for brain tumors. We report the results for benign brain tumors with data from 413 cases (89% response rate), 305 with meningioma, 84 with acoustic neuroma, 24 with other types and 692 controls (84% response rate). For meningioma, analogue phones yielded odds ratio (OR) = 1.7, 95% confidence interval (CI) = 0.97-3.0, increasing to OR = 2.1, 95% CI = 1.1-4.3 with a >10-year latency period. ⋯ For acoustic neuroma, analogue phones gave OR = 4.2, 95% CI = 1.8-10 increasing to OR = 8.4, 95% CI = 1.6-45 with a >15-year latency period, but based on low numbers. Digital phones yielded OR = 2.0, 95% CI = 1.05-3.8, whereas for cordless phones OR was not significantly increased. In the multivariate analysis, analogue phones represented a significant risk factor for acoustic neuroma.
-
Comparative Study
Prevalence of neurological disorders in Bangalore, India: a community-based study with a comparison between urban and rural areas.
A population-based neuroepidemiological survey of 102,557 individuals in urban and rural Bangalore in Southern India was conducted to determine the prevalence and pattern of neurological disorders. The study population included subjects from urban (51,502) and rural (51,055) areas, identified through a two-stage stratified random sampling method. Trained social workers administered the screening questionnaire, which had been tested and validated in an earlier pilot study and a neurologist examined the individuals who screened positive. ⋯ The prevalence rate in urban and rural populations was 2,190 and 4,070/1,00,000, respectively, implying that neurological disorders were twice as frequent in rural areas as in urban areas. The prevalence rates per 100,000 population of the most frequent disorders in the descending order of frequency were: headache (1,119), epilepsy (883), febrile convulsions (330), cerebrovascular disorder (150), and mental retardation (142). This large-scale population-based survey provides data that will be crucial for developing hospital and community-based neurological services in India and other developing countries.
-
Few population studies are available on epidemiological indexes of hereditary ataxias. An investigation on the prevalence rate of these movement disorders is in progress for the Veneto region, the main area of northeast Italy with a population of 4,490,586 inhabitants. The first results of this epidemiological survey concern the province of Padua, which numbers 845,203 residents (January 1, 2002). ⋯ The most common types appeared to be the autosomal dominant forms, namely spinocerebellar ataxia type 1 and 2, with a prevalence of 24 per 1,000,000. In the same population, with a prevalence rate of 6 per 1,000,000, Friedreich's ataxia was defined as the prominent recessive autosomal form. There were very rare cases of ataxia telangiectasia, ataxia with vitamin E deficiency and cerebellar ataxia with congenital muscular dystrophy, a recently identified autosomal recessive disease.
-
Comparative Study
Influence of emergency room fee on acute stroke presentation in a public hospital in Hong Kong.
A new system of emergency room fee-for-service was recently introduced at public hospitals in Hong Kong. A prospective observational study was undertaken to investigate the effects of the emergency room consultation fee system on presentation delay of acute stroke patients and evaluation of timing of patient presentation with acute stroke. We reviewed 2 specified periods (2-month interval each) before and after the consultation fee system at a public hospital. ⋯ Overall, univariate analyses showed that patient age, baseline NIHSS score, consciousness level upon arrival at the emergency department and premorbid ambulatory status were significant factors associated with the timing of presentation after acute stroke. A multivariate linear regression model demonstrated two independent factors: patient age younger than 70 years was independently related to presentation delay, whereas severity of stroke as indicated by unconsciousness upon arrival was associated with shorter delay. While we demonstrated no delays in acute stroke presentation accrued from enactment of the emergency room fee, physicians should endeavor to further explore strategies of reducing the late presentation of acute stroke.