bluuebunny/crossref_metadata_2025_split huggingface dataset:
ALS Incidence in Nova Scotia Over a 20- Year-Period: A Prospective Study
Authors: Bonaparte J.P. , Grant I.A. , Benstead T.J. , Murray T.J. , Smith M. 
Published: December 2014

Objective:Previous studies have suggested that the incidence of amyotrophic lateral sclerosis (ALS) in Nova Scotia is relatively high and increasing over time. This study was performed to determine the current incidence of ALS in Nova Scotia and to compare this to data collected in 1984 and 1995.Methods:All physiatrists and neurologists were surveyed on a monthly basis over one year to record all new cases of ALS diagnosed in Nova Scotia. Data was compared to that collected using similar methods in 1984 and 1995. To validate our methods, we also performed a retrospective study using a provincial health care database.Results:There were 21 new ALS cases in Nova Scotia during the 2003 study period, yielding a crude incidence of 2.24/100,000. The age-adjusted incident rate for 2003 was 2.13 (95% CI = 0.11-4.15). The age-adjusted rate for 1995 was 2.3 (95% CI = 0.08-4.53) while the age-adjusted rate for 1984 was 2.22 (95% CI = 0.13-4.32). Analysis of provincial health records identified 24 cases of ALS and an age-adjusted incidence of 2.44/100,000.Conclusion:The age-adjusted incidence of ALS in Nova Scotia has remained stable over the period 1984-2003. The incidence is similar to that reported in several other parts of the world.
Memory Performance in HIV/AIDS - A Prospective Case Control Study
Authors: Odiase Francis E. , Ogunrin Olubunmi A. , Ogunniyi Adesola A. 
Published: December 2014

Background:Memory impairment, usually impaired retrieval of information, has been described in HIV/AIDS, especially among those with severe illness. Neuro-cognitive disturbances in HIV/AIDS have been linked to poor quality of life and medication adherence. This prospective, case-control study was designed to assess the verbal and non-verbal memory as well as the attention abilities of Nigerian Africans with HIV/AIDS and correlate their performances with their CD4+ T lymphocytes (CD4+) counts.Methods:A total of 288 randomly selected subjects, comprising 96 HIV-positive symptomatic patients, 96 HIV-positive asymptomatic patients and 96 HIV-negative controls, participated in the study. The subjects were age-, sex-, and level of education matched. The Recognition Memory Test and Choice Reaction Time tasks, components of the computer-assisted neuropsychological tests battery- the Iron Psychology ‘FePsy’ were used for cognitive assessments.Results:The mean memory scores of the HIV-positive asymptomatic subjects did not differ significantly from the controls (p>0.05) but the HIV-positive symptomatic subjects' scores were significantly lower than the controls (p<0.05). Both HIV-positive groups had psychomotor slowing and impaired attention (p<0.05). The HIV-positive subjects with CD4+ counts <200/μl and between 200 and 499/μl had significant memory impairment (p<0.001 and p<0.001 respectively) but there was no significant impairment among those with count ≥500/μl. Impaired ability for sustained attention was however present irrespective of the CD4+ level relative to controls (p<0.001).Conclusions:We concluded that there was no significant memory disturbance among HIV-positive asymptomatic subjects despite the presence of impaired attention and psychomotor slowing, and that the severity of immune suppression (as indicated by the CD4+ T lymphocytes count) is a strong determinant of cognitive decline in HIV/AIDS.
Endoscopic Versus Microsurgical Resection of Third Ventricle Colloid Cysts
Authors: Grondin Ron T. , Hader Walter , MacRae M. Elizabeth , Hamilton Mark G. 
Published: December 2014

Objective:Endoscopic resection of colloid cysts has been performed as an alternative to microsurgical resection and stereotactic aspiration since 1982. To date, there are limited published studies comparing these procedures. In this study, we present the largest series of endoscopic resections published to date and compare outcomes to a cohort of microsurgical resections performed at the same institution.Methods:A retrospective chart review was conducted for all patients in the Calgary Health Region undergoing resection of a colloid cyst between 1991 and 2004. Comparison was made between patients treated with endoscopic resection versus microsurgical resection.Results:Twenty-five endoscopic and nine microsurgical procedures were performed. Complete resection was achieved in 24 of 25 procedures in the Endoscopic group, compared with all 9 procedures in the Microsurgical group. Patients in the Endoscopic group had a reduced operative time (mean 104 minutes versus 217 minutes) and reduced length of stay (3.8 days versus 8.4 days) compared to the Microsurgical group. One patient in the Endoscopic group had a complication (hemiparesis/pulmonary embolus). By contrast, 3 patients in the Microsurgical group had complications (seizure, ventriculitis/bone flap infection, and transient memory deficit). There was one recurrence in each group which both occurred at 5 years follow-up. The mean length of follow-up is 38 months in the Endoscopic group and 33 months in the Microsurgical group.Conclusion:Endoscopic resection of colloid cysts can be performed with significantly lower risk of complication than microsurgical resection and with equivalent surgical success. Operative time and length of hospital stay are both significantly reduced with endoscopic resection.
Treatment of Secondary Tonsillar Herniation by Lumboperitoneal Shunt Revision
Authors: Lam Fred C. , Wheatley Matthew B. , Mehta Vivek 
Published: December 2014

Background:Idiopathic intracranial hypertension (IIH) is a condition that usually affects young, obese women. Management is aimed at controlling symptoms of increased intracranial pressure (ICP) and prevention of visual failure due to papilledema. A common surgical treatment for IIH is the insertion of a lumboperitoneal shunt (LP shunt). Secondary symptomatic tonsillar herniation is an uncommon side effect following lumbar cerebrospinal fluid diversion.Methods:We present two cases of symptomatic secondary tonsillar herniation, one associated with a syrinx, in patients with IIH following valved LP shunting. Treatment options for this side effect may include transplanting the shunt to the ventricular system or decompression of the foramen magnum.Results:In our cases we elected to alter the construct of the LP shunt by inserting a programmable valve which led to clinical and radiological reversal of the tonsillar herniation as well as a dramatic reduction in an associated syrinx.Conclusions:When faced with LP shunt induced symptomatic secondary tonsillar herniation, consideration may be given to altering LP shunt dynamics, prior to inserting a ventricular catheter into normal sized ventricles or decompressing the posterior fossa.
Long Survival of Primary Pineal Melanoma with Radiation Treatment Only
Authors: Barron Jane , Morris-Larkin Carolyn , Finch Terry , Maroun Falah , Hache Nanette , Yousef George M. 
Published: December 2014

Pineal gland tumors in adults account for about 0.4 to 1 % of all intracranial tumors. A wide variety of tumors can occur in the pineal gland. The most common are the pineal parenchymal tumors (pineocytomas, pineoblastomas, and pineal parenchymal tumors of intermediate differentiation), germ cell tumors, and glial tumors. Uncommonly in the pineal gland one may encounter a metastatic tumor, a meningioma or a melanoma.We here report a case of primary pineal gland melanoma with prolonged survival of 56 weeks after radiotherapy alone. To our knowledge, this is the first reported case of prolonged survival after radiotherapy alone, without surgical intervention or chemotherapy. Contrary to previous reports, our case demonstrates that a pineal melanoma with leptomeningeal dissemination can still yield a better survival with radiation treatment only.
Group Education with Personal Rehabilitation for Idiopathic Parkinson's Disease
Authors: Guo Liping , Jiang Yuping , Yatsuya Hiroshi , Yoshida Yoshitoku , Sakamoto Junichi 
Published: December 2014

Objective:To evaluate the effect of a group education program with personal rehabilitation for idiopathic Parkinson's disease (IPD).Methods:A single-blind, randomized, controlled clinical trial, with a pre-test/post-test quasi-experimental design. Fortyfour stable, non-demented patients with IPD were randomly assigned to an intervention group (n=23) and control group (n=21). Three group lectures on health education specific to IPD were delivered to the intervention group. The theme of lectures was “Not a lonely journey, as your friend, we—experts specializing in IPD— would love to join with you.” Three domains of the management of IPD were mentioned: “How to manage your routine Meal, Moving and Mood after suffering from IPD” Each lecture was scheduled for 45 minutes (excluding breaks), and designed as an interactive dialogue rather than a traditional lecture. To strengthen the impact of the lectures, relevant information was published on a website: http://www.parkinsonism.cn/. Following the group lecture, individualized and tailored rehabilitation made up of 24 half-hour sessions over eight weeks were provided for the intervention group.Results:The program ran smoothly and IPD patients were satisfied with this program. After only eight weeks, the health-related quality of life (HR-QOL) in the intervention group improved significantly (p<0.001). Patients and their caregivers in this group also reported their mood elevations following the program.Conclusion:Group education combined with personal rehabilitation program appears to be a beneficial and practical intervention, not only complementing the medical treatment for IPD patients but also meeting the growing demand for long-term care.
Bulbar Signs in Normal Population
Authors: Lim K S , Hew Y C , Lau H K , Lim T S , Tan C T 
Published: December 2014

Background and Objectives:There is lack of published data on bulbar signs among the healthy population. This study aims to determine the range of normality of bulbar signs particularly among the elderly.Methods:Systemic examination of bulbar signs was carried out according to a predetermined protocol on a cohort of young and elderly healthy subjects.Results:A total of 206 subjects were recruited in the study, 104 young adults with mean age of 20 years, and 102 elderly with mean age of 73 years. Uvula deviation was seen in 28 (26.9%) young subjects and 22 (21.6%) elderly. Irregular tongue border was seen in 17 subjects, unilateral in 4 subjects. Fourteen (6.8%) subjects had deviation on tongue protrusion. Occasional tremor of tongue on protrusion is common in both young and old. Persistent (severe) tongue tremor on protrusion was seen in 18.6% of the elderly, and 4.8% of the young. None of the subjects had tremor of tongue at rest. In gag reflex, absence of gagging response was common in elderly, seen in two thirds of the subjects on stimulation of the posterior pharyngeal wall. However, all the subjects had uvular movement. Habituation or suppression of gagging response was seen in close to 90% of young males.Conclusion:There is wide range of normality in bulbar signs in normal population, particularly among the elderly.
Malformations of the Fetal Dural Sinuses
Authors: McInnes Matthew , Fong Katherine , Grin Andrea , ter Brugge Karel , Blaser Susan , Halliday William , Shannon Patrick 
Published: December 2014

Background:Dural sinus malformation (DSM) is a term used to describe congenital vascular malformations characterized by massive dilation of one or more dural sinuses: these dilatations are typically associated with arteriovenous shunts. Such malformations can present antenatally but their early natural history and anatomy is poorly defined.Methods:We reviewed five years of autopsy experience and retrieved three primary vascular malformations of the fetal dural sinuses with ultrasound, magnetic resonance imaging (MRI) and post-mortem correlation.Results:Fetal ultrasound and MRI obtained between 19 and 23 weeks gestational age demonstrated in all cases dilation of the dural sinuses. In two cases vascular thromboses were present in either the dilated dural sinus (one of three) or the associated arteriovenous fistula (one of three). All cases were autopsied at 22-23 weeks gestational age. In one there was imaging and autopsy evidence of remodeling of the dural sinuses associated with a pial arteriovenous fistula. In two cases, no arteriovenous malformation was identified on initial imaging, but only became evident at autopsy. One case showed morphological overlap with vein of Galen aneurysmal malformation, with a midline arteriovenous shunt and vein of Galen ectasia. The other demonstrated a perisylvian dural arteriovenous fistula.Conclusion:In utero thrombosis of feeding vascular malformations or of the dural sinus malformation may be prominent. The early in utero developmental trajectory of dural sinus malformation (DSM) is poorly defined and deserves further study.
Early Ischemic Stroke Presentation in Pakistan
Authors: Kamal Ayeesha Kamran , Khealani Bhojo Asumal , Ansari Sajjad Ahmed , Afridi Maria , Syed Nadir Ali 
Published: December 2014

Introduction:There are no studies from Pakistan that describe stroke presentation rates or factors associated with early or delayed presentation. This is important to know because current clinical protocols limit the use of recombinant tissue plasminogen activator (rtPA), the only available therapy for acute ischemic stroke, to a three-hour window from symptom onset.Methods:All patients aged 14 years or above with acute ischemic stroke of ≤ 48 hours duration were prospectively identified from the Aga Khan University Stroke Data Bank over a 22-month period ending May 2001.Results:269 ischemic stroke patients presented within 48 hours of stroke onset. 55 out of 269 (21%) presented within first three hours and 110 out of 269 (41%) within first six hours. Unawareness of treatment options (p <0.001) and inappropriate diagnosis and field triage (p=0.005) were associated with delayed presentation. Small vessel occlusion or lacunar stroke in the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) ischemic stroke subtype was associated with delayed presentation (p=0.047) and cardioembolic stroke was associated with earlier presentation (p=0.048). Stroke severity assessed with the National Institutes of Health Stroke Scale at a cut off score of ≥ 15 was not associated with earlier time to presentation at three hours (p=0.114) but there was some tendency at six hours (p=0.097).Conclusions:The rate of early stroke presentation in a Pakistani tertiary care facility is comparable to certain developed countries. To increase the proportion of patients who can benefit from thrombolytic therapy, programs need to be instituted to increase public awareness of treatment options for stroke and expedited referral by the primary care provider.
Migraine: Prevalence and Associated Disability Among Nigerian Undergraduates
Authors: Wahab Kolawole Wasiu , Ugheoke Asuwemhe Johnson 
Published: December 2014

Background:Studies on migraine in Nigeria are scanty while the disability associated with the disease has not been determined. We aimed at determining the lifetime prevalence of migraine and its associated disability among the students of a Nigerian university.Method:Using a multi-stage sampling method, undergraduates of Ambrose Alli University, Nigeria were screened with the International Headache Society (IHS) criteria. Those who satisfied the criteria for migraine were then assessed with the Migraine Disability Assessment questionnaire to ascertain the level of disability resulting from migraine in the three months preceding the study. Information was also obtained on the use of preventive and abortive medications.Results:Out of the 1513 respondents screened, 145 satisfied the IHS criteria for the diagnosis of migraine giving an overall lifetime prevalence of 9.6% (females 10.3%, males 8.9%, p>0.05). Migraine associated disability was little or none in 53.1% (males 55.2%, females 51.3%, p>0.05), mild in 10.3% (males 11.9%, females 9.0%, p>0.05), moderate in 20.7% (males 20.9%, females 20.5%, p>0.05) and severe in 15.9% (males 11.9%, females 19.2%, p>0.05). In spite of the fact that 53 (36.6%) of the migraineurs had moderate-severe disability, only 19/53 (35.8%) reported being on preventive treatment while none had ever used a triptan.Conclusion:Prevalence of migraine among our respondents falls within the range reported from similar studies among university students outside Africa. In spite of the high disability associated with the disease, use of effective preventive and abortive therapies is very poor.
Neuroleptic-Induced Tardive Cervical Dystonia: Clinical Series of 20 Patients
Authors: Godeiro-Junior Clecio , Felício Andre C. , de Carvalho Aguiar Patrícia , Borges Vanderci , Silva Sonia M. A. , Ferraz Henrique B. 
Published: December 2014

Background:Cervical dystonia (CD) may be classified according to the underlying cause into primary or secondary CD. Previous exposure to neuroleptics is one of the main causes of adult-onset secondary dystonia. There are few reports that characterize the clinical features of primary CD and secondary neuroleptic-induced CD. Herein our aim was to investigate a series of patients with neuroleptic induced tardive CD and to describe their clinical and demographic features.Patients and Methods:We retrospectively evaluated 20 patients with neuroleptic-induced tardive CD and compared clinical, demographic and therapeutic characteristics to another 77 patients with primary CD. All patients underwent Botulinum toxin type-A therapy.Results:We did not identify any relevant clinical and demographic characteristics in our group of patients that could be used to distinguish tardive and primary CD.Conclusion:Patients with tardive CD presented demographic characteristics and disease course similar to those with primary CD.
The Cardiac R-R Variation and Sympathetic Skin Response in the Intensive Care Unit
Authors: Bolton Charles , Thompson Jillian , Bernardi Linda , Voll Christopher , Young Bryan 
Published: December 2014

Background and Purpose:The central and peripheral nervous systems are often affected in intensive care unit (ICU) patients, especially those with prolonged assisted ventilation and sepsis or systemic inflammatory response syndrome (SIRS). The autonomic nervous system, however, has been under-investigated in such patients. We evaluated autonomic nervous system (ANS) function in 29 ICU patients with various neurological disorders.Methods:Testing involved cardiac R-R variation (CRRV) as an index of parasympathetic function and the sympathetic skin response (SSR) for sympathetic assessment.Results:Only those 8 patients with sepsis-related neuropathy or encephalopathy had abnormal CRRV, while the SSR was absent in all but 2 patients.Conclusions:Our preliminary study revealed a high incidence of autonomic dysfunction in ICU patients with various neurological disorders.
Parkinson's Disease, Multiple Sclerosis and Changes of Residence in Alberta
Authors: Yiannakoulias Nikolaos , Schopflocher Donald P. , Warren Sharon A. , Svenson Lawrence W. 
Published: December 2014

Background:Our objective is to examine how persons diagnosed with Multiple Sclerosis (MS) and Parkinson's disease (PD) change residence following disease onset. We hypothesize that persons choose to change residence (locally or regionally) in different ways depending on whether or not they have been diagnosed with MS/PD. We also estimate the effects of residence change on measures of disease prevalence made at several different levels of geography.Methods:Using fee-for service and hospitalization data, we identify cases of MS and PD between 1994 and 2004. Both of these case groups are matched to controls based on age, sex, socioeconomic status and municipality of residence. We tabulate and compare the changes of residence among persons in the case and control groups. We also use these data to estimate the effects that changes in residence have on disease prevalence at three different levels of geography.Results:Both MS and PD patients were more likely to change residence following disease onset compared to groups of matched controls (p<=0.001). Most changes of residence occur within the same municipality. The total magnitude of these changes is small, however, and is unlikely to affect estimates of disease prevalence; over our study period, the largest change in geographical prevalence estimates due to individual changes in residence was about 1%.Conclusions:Persons diagnosed with MS and PD both have mobility characteristics that differ from those of their respective control groups, and in general, are more likely to move to or between Edmonton and Calgary, and less likely to move out of province. However, the balance of mobility characteristics of persons with PD and MS appear unlikely to greatly affect the patterns observed on maps of disease prevalence.
National Human Resources Survey of Clinical Neurophysiologists in Canada
Authors: Chan K. Ming , Young G. Bryan , Warren Sharon 
Published: December 2014

Background:Although electromyography (EMG), electroencephalography (EEG) and evoked potential (EP) studies are common investigation tools for patients with neurologic illnesses, no formal data on the manpower supply in Canada exists. Because of the importance of these on training requirements and future planning, the purpose of this study was to establish a comprehensive profile of the human resources situation in clinical neurophysiological services across Canada.Methods:A questionnaire was sent to all clinical neurophysiologists in Canada. To capture the maximal number of respondents, a total of three rounds of mail out were done. In addition, to obtain accurate demographic data on supporting technologists, a separate survey was also carried out by the Association of Electrophysiological Technologists of Canada.Results:Of the 450 clinical neurophysiologists identified and surveyed, the provincial response rate was 59±14% (mean±SD). Of these, the vast majority practiced in urban centres. There was substantial regional disparity in different provinces. While the wait time for most EEG and EP laboratories was less than six weeks, the wait time for EMG was substantially longer. With the age of the largest number of practitioners in their sixth decade, projected retirement over the next 15 years was 58%. The demographic distribution of the supporting technologists showed a similar trend.Conclusions:In addition to considerable regional disparity and urban/rural divide, a large percentage of clinical neurophysiologists and supporting technologists planned to retire within the coming decade. To ensure secure and high standard services to Canadians, solutions to fill this void are urgently needed.