Mortality, major neurological handicaps--including mental retardation, cerebral palsy and epilepsy--educational subnormality and height at 14 years of age were studied by birth weight percentiles in a birth cohort of 12 000 children from northern Finland. Infant mortality was significantly higher below the mean -2 SD, 10th and 25th percentiles, than in the median class, from 25th to 75th percentiles, but mortality from one to 14 years only in the lowest weight class. Educational subnormality, including mental retardation +/- some other handicap, was highly significantly more frequent in all the percentile classes lower than the median class but showed no significant tendency to be less frequent in the percentiles over the median. It was also highly significantly more frequent among the preterm than the term infant. The number of children with a major neurological handicap but normal school performance did not vary significantly by birth weight percentiles or by gestational age. Height at 14 years increased significantly by birth weight percentiles. The height of the boys with birth weight mean - and +2 SD was nevertheless within the 25th-75th percentiles for height at 14 years in general, while the height of the girls came close to these percentile limits. The preterm infants were significantly shorter than the term infants at 14 years.
The paper presents some methodological problems concerning modeling of the processes of accumulation and prevalence of the pathological states caused by head injury in the population. The trend in the number of annual cases of new injuries of the head is estimated for at least 10 years for different age groups of the population. The average indices are estimated together with the limits of their fluctuations. Taking into consideration the mean expectation of life both the average annual quantity of the individuals with head injury in the anamnesis and probability of their accumulation are determined. This index equals to 22.22 per 1000. The frequency of the craniocerebral traumas was estimated in comparison with the total quantity of head injuries: 18.7 +/- 3.18% for children; 38.6 +/- 3.97% for the adults.
Reliable information on acute viral infections of the central nervous system (CNS) in Canadian children has not been available. To investigation this disease in Halifax the medical records of 180 patients with presumed or definite acute viral CNS infection diagnosed at the Izaak Walton Killam Hospital for Children over an 8-year period were reviewed. The yearly incidence was estimated at 19.5/100 000 for children up to 16 years of age, and the peak incidence was in July, August and September. The cause was determined in 64 (36%) of the 180 patients; it was most commonly a known infectious disease -- mumps (in 24 patients) or varicella (in 9 patients). An enterovirus was responsible in nine cases, herpes simplex virus in eight and measles virus in six. The clinical manifestations were variable and included apnea in three infants who would otherwise have been considered to have nearly suffered the sudden infant death syndrome. Localizing features were present on the electroencephalograms of nine patients, including six with herpes simplex infection. Serologic study of paired serum samples obtained during the acute phase of the illness and during convalescence was the most useful laboratory method of establishing the diagnosis. As medical therapy for specific causes of acute viral CNS infection advances, greater attention should be placed on establishing the correct diagnosis.
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To study plasma concentrations of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and S-100B during intensive care after out-of-hospital cardiac arrest from ventricular fibrillation (OHCA-VF), and their associations with the duration of ischemia, organ dysfunction and long-term neurological outcome.
A 12-month prospective observational multicentre study was conducted in 21 Finnish intensive care units in 2011. IL-6, hs-CRP and S-100B were measured at 0-6 h, 24 h, 48 h and 96 h after ICU admission. Associations with the time to return of spontaneous circulation (ROSC), sequential organ failure assessment (SOFA) scores divided into tertiles and 12-month cerebral performance category (CPC) were tested.
Of 186 OHCA-VF patients included in the study, 110 (59.1%) patients survived with good neurological outcome (CPC 1-2) 12 months after cardiac arrest. Admission plasma concentrations of IL-6 but not hs-CRP were higher with prolonged time to ROSC (p
Although the care of inpatients is an important aspect of radiation oncology practice in many countries, it has never been studied in detail. The goal of this study was to describe the admissions to a radiation oncology inpatient service over a 1-year period with respect to patient characteristics, primary malignancies, common nonmalignant diagnoses, use of radiotherapy and outcome of admission.
Using computerized hospital databases, we analysed the utilization of 11 radiation oncology beds in a 424-bed teaching hospital from March 31, 1991, to April 1, 1992.
There were 342 admissions of 277 patients. The median age was 66.5 years; the male:female ratio was 1:1. The commonest primary neoplastic diagnoses were lung (42%), gynecological (15%), genitourinary (14%) and breast (8%) cancers. Only 17% of the patients had cancer as the sole diagnosis; most patients had multiple medical diagnoses. Infections (22%), neurological (20%), cardiovascular (13%) and endocrine (9%) conditions were the commonest. Mean length of stay was 11.25 days. Most of the admissions (71%) resulted in discharge to the patient's home; few patients (15%) died. Only half of admissions involved radiotherapy, indicating that the focus of patient care was the medical treatment of cancer complications or other active medical problems.
These data show that radiation oncology inpatients have complicated medical problems, and they support the training of radiation oncologists in the comprehensive medical care of patients.
To investigate the temporal relationships between a range of neurological diseases and affective disorders.
Data derived from linkage of the Danish Psychiatric Central Register and the Danish National Hospital Register. Seven cohorts with neurological index diagnoses and two control group diagnoses were followed for up to 21 years. The incidences of affective disorders in the different groups were compared with the control groups, using competing risks to consider the risk of affective disorder and the risk of death in the same analysis.
We found an increased incidence of affective disorders in dementia, Parkinson's disease, epilepsy, stroke and intracerebral haemorrhage compared with control groups. The association was found to be the strongest for dementia and Parkinson's disease. In hospitalized patients, with incident multiple sclerosis, the incidence of affective disorder was lower than the incidence in the control groups.
In neurological diseases there seems to be an increased incidence of affective disorders. The elevated incidence was found to be particularly high for dementia and Parkinson's disease (neurodegenerative diseases).
The analysis of the level and pattern of morbidity among rural adolescents indicates that the leading causes of visits both to out-patient and in-patient facilities are diseases of respiratory and digestive tract, diseases of the central nervous system and sense organs. To promote better health of rural adolescents it is recommended to establish in summer months preventive facilities at industrial training classes which will enable the adolescents to undergo a course of physiotherapy and drug treatment, medical physical exercises and phytotherapy.