Rehabilitation: the Cinderella of neurological research? A bibliometric study     

Tesio L.  Gamba C.  Capelli A.  Franchignoni F. P. 《The Italian Journal of Neurological Sciences》1995,16(6):473-477

Rehabilitation is under-represented in the neurological literature on disabling diseases. A Medline search was conducted to retrieve the articles published between January 1991 and June 1994 under the main headings of Stroke, Parkinson's disease, Multiple sclerosis, Brain injury, Ataxia and Dementia. These were then combined with the sub-heading Rehabilitation. The former search yielded 27724 articles, the latter 1272 (4.6%). In 1992, the Journal of Citation Reports (JCR) assigned to Journals publishing rehabilitation papers an average Impact Factor (IF) of 0.7–2.8 (median 1.8): that is, 31–90% (depending on the various main headings, median 68%) of the average IF given to Journals publishing non-rehabilitation papers. In the present study, the weight of the literature was defined as the product of the number of articles multiplied by the IF of the corresponding Journal (IF=0 for non-JCR Journals). Across the various neurologic conditions, the weight of the Rehab literature was 0.1–7% (median 2%) of the weight of the non-Rehab literature. The results suggest that neurology is still reluctant to face the disability challenge.

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Sommario La riabilitazione è scarsamente rappresentata nella letteratura neurologica sulle patologie che causano disabilità. Gli Autori hanno interrogato la banca-dati Medline nella ricerca degli articoli pubblicati fra il Gennaio 1991 ed il Giugno 1994 sotto le parole-chiave Stroke, Parkinson's disease, Multiple Sclerosis, Brain injury, Ataxia e Dementia. È stato poi eseguito un incrocio con la parola-chiave secondaria Riabilitazione.La prima ricerca ha prodotto 27724 articoli mentre la seconda ne ha prodotti 1272 (4.6%). Nel 1992 il Journal of Citation Reports (JCR) ha attribuito alle Riviste che hanno pubblicato articoli con tema riabilitativo un Impact Factor (IF) medio di 0.7–2.8 (mediana 1.8), pari al 31–90% (a seconda della parola-chiave principale: mediana delle percentuali 68%) dell'IF medio attribuito alle Riviste che hanno pubblicato soltanto articoli su temi non riabilitativi. In questo studio è stato definito come peso della letteratura il prodotto del numero di articoli per l'IF delle rispettive Riviste (IF=0 per le Riviste non censite dal JCR). A seconda delle diverse patologie neurologiche, il peso della letteratura riabilitativa variava fra 0.1 e 7% (mediana 2%) del peso della letteratura non riabilitativa.I risultati suggeriscono che la Neurologia sia ancora riluttante ad affrontare la sfida che le pone la disabilità.

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The sunflower syndrome. A new look at "self-induced" photosensitive epilepsy     

F R Ames  D Saffer 《Journal of the neurological sciences》1983,59(1):1-11

The stereotyped, episodic abnormal behaviour manifested by a child and her mother on exposure to a particular sort of sunlight is described in detail. The child is the first fully documented patient with this so-called "self-induced" form of photosensitive epilepsy in whom for several years no electroencephalographic sensitivity to flickering light could be demonstrated. The probability that the cingulate circuit may be the anatomical substrate involved in the pathogenesis of these patients' unusual response to sunlight is discussed. Both patients also exhibited remarkably persistent habit rhythmias--the one common to both being that of circling.  相似文献   

针灸联合西药治疗中风恢复期随机平行对照研究     

薛青理 《实用中医内科杂志》2014,(10):125-126

[目的]观察针灸联合西药治疗中风恢复期疗效。[方法]使用随机平行对照方法,将60例住院患者按病志号抽签简单随机分为两组。对照组30例营养神经细胞及促进脑组织功能恢复、胞二磷胆碱及脑活素等;颅内压高降颅压。治疗组30例取阳陵泉、风池、四神聪、曲池、外关、内关、合谷、丰隆、太冲、风市以及环跳,平泻、平补,留针30min;肘部拘挛加小海、三里;踝部拘挛加照海、太溪、解溪;膝部拘挛加阳谷、曲泉;手指部拘挛加后溪、八邪;烦躁加大陵、内关;言语不利加通里、哑门、廉泉;西药治疗同对照组。连续治疗10d为1疗程。观测临床症状、神经功能缺损程度评分、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组痊愈14例,显效9例,有效5例,无效2例,总有效率93.33%。对照组痊愈7例,显效10例,有效8例,无效5例,总有效率83.33%。治疗组疗效优于对照组(P0.05)。神经功能缺损程度评分两组均有明显降低(P0.01),治疗组降低优于对照组(P0.05)。[结论]针灸联合西药治疗中风恢复期效果显著,值得推广。  相似文献   

Inability to self-report pain after a stroke: A population-based study     

Jonathan H. Smith  Kari L. BottemillerKelly D. Flemming  F. Michael CutrerEdythe A. Strand 《Pain》2013

The frequency of not being able to self-report pain after a stroke has not been previously assessed in a population-based sample. We studied the epidemiology of this problem using a cohort of patients hospitalized after a stroke in Olmsted County, Minnesota, from June 1, 2008, to June 1, 2012. Overall, 52 of 388 (13.4%) individuals were unable to provide a meaningful response to either a Faces Pain Scale or Numerical Rating Scale on admission. Inability to self-report pain was associated with measures of stroke severity (P < .0001), aphasia severity (P < .0001), and level of consciousness (P < .0001). Inability to self-report pain on admission was further associated with either subsequent death during the hospitalization (P < .0001) or an inability to provide self-report on dismissal (P < .0001). Our study further defines the epidemiology of the inability to self-report pain after a stroke as being less common than previously thought. Attempts to validate observational pain scales for poststroke patients should focus on those individuals with aphasia and/or depressed levels of consciousness.  相似文献   

神经内科医护人员对护士专科培训需求的调查研究     

毛永香  邢凤  全凤英  范玉兰  曾晓鹏  刘丽萍  赵庆华  刘光维 《护士进修杂志》2011,26(17):1596-1598

目的 了解和比较神经内科医护人员对护士专科培训的需求,为制定神经内科专科护士规范化培训课程提供依据.方法 采用问卷调查法,调查重庆地区21所医院从事神经内科工作的178名护士和138名医生对现行神经内科护士专科培训的需求.结果 21％的医生和42.7％的护士对现有神经内科护理质量不满意;99.28％的医生和94.4％的...  相似文献   

Diagnostic algorithm for relapsing demyelinating syndromes of the CNS in children     

Yael Hacohen  Kshitij Mankad  W Kling Chong  Frederik Barkhof  Angela Vincent  Ming Lim  Evangeline Wassmer  Olga Ciccarelli  Cheryl Hemingway 《Lancet》2017

Background

Paediatric relapsing demyelinating syndromes of the CNS define a group of diseases that have different phenotypes. Although for some of them, such as multiple sclerosis and neuromyelitis optica spectrum disorder (NMOSD), diagnostic criteria have been developed, diagnostic uncertainties are not uncommon. We aimed to identify the key features that unify phenotypes, and focused on patients with myelin oligodendrocyte glycoprotein (MOG) antibodies, to investigate whether they show distinctive clinical and radiological features, independently of their original diagnosis. We then generated a diagnostic algorithm for clinical use.

Methods

We reviewed the clinical characteristics, MOG and AQP4 antibodies, intrathecal oligoclonal bands, and Epstein-Barr virus serology results of 110 children with relapsing demyelinating syndromes. A neuroradiologist, masked to the diagnosis, scored the MRI scans. Clinical, radiological, and serological test results were compared between the different relapsing demyelinating syndromes.

Findings

62 children (56%) were diagnosed with multiple sclerosis, 27 (25%) with NMOSD, 14 (13%) with multiphasic disseminated encephalomyelitis (MDEM), and 7 (6%) with relapsing idiopathic optic neuritis (RION). Paediatric multiple sclerosis and NMOSD with AQP4 antibodies showed radiological and serological features typical of the respective adult phenotypes. Eight children with NMOSD (30%) were positive for AQP4 antibodies. MOG antibodies were found in 16 (83%) of 19 NMOSD patients without AQP4 antibodies, in all 14 children with MDEM, and in two with RION (33%). Children with MOG antibodies were younger, less likely to present with area postrema syndrome, had lower disability, longer time to relapse, and more cerebellar peduncle lesions than those with AQP4 antibody-positive NMOSD (all p<0·05). A diagnostic algorithm, applicable to any episode of CNS demyelination, led to four main relapsing demyelinating syndromes: multiple sclerosis, NMOSD with APQ4 antibodies, MOG-antibody-associated disease, and antibody-negative relapsing demyelinating syndrome.

Interpretation

Using an integrative approach of clinical phenotyping, radiological analysis, and MOG and AQP4 antibodies, we were able to delineate patients to different disease phenotypes—namely, multiple sclerosis, MOG antibody spectrum disorder, and AQP4 antibody spectrum disorder. Although the clinical presentation can overlap (eg, optic neuritis and transverse myelitis) the pathogenic mechanisms are likely to be different. A correct diagnosis in children with non-multiple sclerosis phenotypes has both treatment and prognostic implications.

Funding

National Institute for Health Research.  相似文献   

Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review and Meta-analysis     

Balwinder Singh  Ajay K. Parsaik  Larry J. Prokop  Manoj K. Mittal 《Mayo Clinic proceedings. Mayo Clinic》2013,88(10):1056-1065

ObjectiveTo consolidate the evidence from randomized trials for the use of endovascular therapy (ET) in patients with acute ischemic stroke.MethodsWe searched major databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus) from their inception to February 12, 2013, for randomized trials evaluating the efficacy of ET compared with standard of care for acute ischemic stroke. Pooled absolute and relative risk estimates were synthesized by using a random-effects model. Heterogeneity was assessed by using Q statistic and I² statistic. Subset analysis was performed for patients with severe stroke (National Institutes of Health Stroke Scale score ≥20). The study was conducted from January 15, 2013 to April 30, 2013.ResultsOf the 1252 retrieved articles, 5 randomized trials enrolling 1197 patients with acute ischemic stroke were included. Seven hundred eleven patients received ET, and 486 received intravenous (IV) tissue plasminogen activator. There was no significant improvement in any of the outcomes in patients receiving ET compared with those receiving IV thrombolysis. On subgroup analysis, ET was found to have better outcomes in patients with severe stroke (National Institutes of Health Stroke Scale score ≥20), showing a dose-response gradient and improving excellent, good, and fair outcomes by an additional 4%, 7%, and 13%, respectively, compared with IV thrombolysis.ConclusionOverall, ET is not superior to IV thrombolysis for acute ischemic strokes (level B recommendation). However, ET showed promise and improved outcomes in patients with severe strokes, but the evidence is limited due to sample size. There is a need for further trials evaluating the role of ET in this high-risk group.  相似文献   

北京市区县二级医院神经内科医疗资源现况调查与对策     

Wang YL  Wang YJ  Zhao XQ  Liao XL  Wu D  Yang YQ  Hu CM  Chen QD  Yang Q 《中华内科杂志》2007,46(4):302-305

目的对北京二级医院神经内科的医疗服务进行现况调查。方法对北京市66家二级医院进行定性与定量结合的普查。结果收治的病种以脑血管病为主（84％）。城区二级与三级医院的比例为58：60;而远郊区县为48：6。远郊区县中,能提供尿激酶和组织纤溶酶原激活剂（t-PA）溶栓治疗的医院仅占64．7％和26．5％。结论担负脑血管病救治重任的远郊二级医院尚不能满足需求。应加强培训、建立远程医疗模式。  相似文献   

    

Majdi Hamadeh  Khalil Nasrallah  Zeinab Ajami  Rahil Zeaiter  Layan Abbas  Samih Hamadeh  Jawad Fares 《Clinical Medicine & Research》2021,19(2):90

McArdle disease, also known as glycogen storage disease type V, is an autosomal recessive disease due to the absence of myophosphorylase activity, leading to the complete disruption of glycogen breakdown in muscles. We present a rare case of a Caucasian male, aged 26 years, who developed rhabdomyolysis-induced acute renal failure and uremic encephalopathy. Neurological examination and histopathological studies supported the diagnosis of McArdle disease. The severity of his symptoms necessitated urgent hemodialysis, upon which the patient reported improvement in status. Acute renal failure in McArdle disease usually resolves with supportive treatment and maintenance of regular physical activity. Nevertheless, in more severe cases, intensive care with urgent hemodialysis may be needed. A multidisciplinary approach is necessary for the adequate management of similar cases.  相似文献   

临床护理人员分层级管理对神经科护理服务质量的影响     

郭东方  张旭 《临床心身疾病杂志》2020,26(2):167-169

目的探讨临床护理人员分层级管理对神经科护理服务质量的影响.方法将我院52名神经科护理人员实施常规管理设为实施前组,2017年3月-2018年2月在常规管理基础上实施分层级管理设为实施后组.比较实施分层级管理前后护理人员的护理质量优良率、护理理论知识及操作技能考核成绩、患者护理满意度.结果实施分层级管理后本组护理人员护理理论知识、操作技能考核成绩均显著高于实施前(P<0.01);护理质量优良率(93.8%)、患者护理满意度(95.0%)显著高于实施前(80.8%、86.5%)(P<0.01).结论对神经科护理人员实施分层级管理,能显著提高护理人员的护理理论水平,增强护理操作技能,改善护理质量,提高患者的护理满意度.  相似文献