Epidemiologia della sclerosi multipla. Attualità degli studi descrittivi ed eziologici a Ferrara

Review degli studi di epidemiologia descrittiva sulla sclerosi multipla nel mondo, con particolare approfondimento sulla ricerca in Itali

Terapia medica dell'epilessia: nozioni pratiche per un coretto trattamento

Nozioni pratiche per un coretto trattamento delle varie forme di epilessi

Intrathecal synthesis of interleukin-12 in multiple sclerosis

Intrathecal synthesis of interleukin-12 in multiple sclerosi

Le emianopsie omonime pure:correlazioni clinico - tomodensitometriche

Correlazioni cliniche e anatomo-funzionali e di neuroimaging delle emianopsi

Epilessia temporale e disordini psichici: studio clinico, EEG e PET di un caso

Studio clinico, elettroencefalografico, completato con analisi PET di un caso di epilessia del lobo temporal

Astrocitoma del tronco encefalico: considerazione cliniche e problemi diagnostici

Gli autori descrivono alcuni casi peculiari di astrocitoma localizzato nel tronco encefalic

Abnormalities of fast , middle- and long-latency auditory evoked potentials (0-4000) in multiple sclerosis

Studi di neurofisiologia e vestibologia nella sclerosi multipl

Concurrent Bell's palsy and diabetes mellitus: a diabetic mononeuropathy?

Correlazioni tra la paralisi periferica del nervo facciale idiopatica di Bell e diabete mellit

Temporal trend and factors associated with delayed hospital admission of stroke patients

The effectiveness of stroke treatment depends on the time interval between onset of symptoms and admission to hospital. The purpose of our investigation was to assess, over a 10-year period, the mean delay in admission to hospital in stroke patients to determine factors which might be associated with this delay, to define the putative number of patients available for accrual in clinical trials, and to identify strategies aimed at decreasing the time to admission. We collected data on all stroke patients consecutively admitted to our clinic from 1986 to 1995. The following variables were investigated: age, sex, educational and occupational level, home accommodation, family and personal history of vascular disease or factors known to affect the risk of vascular disease, and type and severity of stroke. The individual and independent contribution of these variables was assessed by univariate and multivariate analysis. The accurate time of stroke onset was established for 760 patients. Of these, 24.7% were admitted within 1 h from the onset of symptoms, 41% within 2 h, 54% within 4 h and 72.5% within 12 h. The mean delay was 21\ub12 h (SE) and the median was 3.5 h. Acute onset of neurological deficits, stroke severity and family history of cerebrovascular disease were associated with earlier presentation. According to the current guidelines for thrombolytic therapy, only 16% of the patients could have been included in a clinical trial. This study suggests that despite a relatively short time to hospital admission in most patients and an altered help-seeking behavior over time, many stroke patients did not present early enough to be recruited for clinical trials or to benefit from new treatments. The majority of patients with timely presentation were not eligible for acute treatment, or were subjects with severe stroke for whom caution is advised before initiating thrombolytic therapy. It has been suggested that the patient's indecision to seek medical help is the most important reason for a delayed hospital admission of stroke patients. These results underscore the importance of interventions aimed at reducing the delay in stroke treatment induced by patients who are unaware of the decisive role of the time of treatment induction. The finding that earliest admissions for stroke comprised patients with a previous history of cerebrovascular disease suggests that an education campaign might highlight the importance of an early admission