An approach to establishing a health information market.

The Tempus CME project "Regional Network for Healthcare Management" was aiming to perform a feasibility study for a communication network dedicated to the healthcare field. The needs assessment survey as well as the debates during the working sessions and during the conference on how communication can support a better healthcare delivery, substantiated the approach for achieving the Romanian health information market. The proposed communication network can be considered as a national information infrastructure offering good links between health, education, research and industry and a unique frame for information providers and users, for the estate and private companies.

Acetazolamide therapy evaluation in haemorrhagic stroke.

The influence of acetazolamide in patients with hemorrhagic stroke was assessed in 54 patients in comparison with the influence of other therapies in 68 patients included in a control group. Modified Rankin Scale and mortality rate were evaluated at three different moments: onset, 72 hours and control (3 weeks-one month from the onset). A better outcome was seen when acetazolamide was given.

Stroke and hypertension. Antihypertensive therapy withdrawal.

The effect of antihypertensive therapy withdrawal in acute ischaemic stroke patients was assessed in order to establish possible correlations between blood pressure values and the modified Rankin Scale (mRS) outcome. One hundred and twelve consecutive patients with acute ischaemic stroke and hypertension were treated with relatively similar regimen. Seventy-two hours following the onset of stroke, systolic blood pressure decreased to < or = 180 mmHg in 110 patients.

Postoperative outcome of intracranial meningiomas; long-term prognosis.

A retro- and prospective study was carried out in 150 patients who underwent surgery for benign (grade I) intracranial meningiomas (ICM). The mean duration of the follow-up was of 4 years. The subjects were divided into 4 groups according to the intervals of follow-up examination.

Cognitive and motor retardation in depression.

The study analysed the profile of psychomotor retardation in depression by clinically and psychometrically assessing its motor, speech and cognitive components. Psychomotor performance level of a group of 100 moderately depressed patients was significantly lower than that of controls on most psychometric tests. The interrelations among the variables evaluating various aspects of the depressive psychomotor retardation were examined and factor analyses were performed.

Predictors of outcome in depression.

Several socio-demographic, family and clinical history variables, stressful life events, index episode characteristics, symptom severity, clinically and psychometrically assessed personality type and traits, and treatment were evaluated as potential predictors of multiple outcome criteria in a sample of 157 outpatients and inpatients meeting commonly used criteria for depression episodes. Outcome criteria included: severity scores on the final evaluation, improvement rate, impairment level of functioning, clinically rated treatment response, episode duration and relapse frequency in one year follow-up. Gender, personality structure and type, stressful life event characteristics, prior episode number, clinical status after the last episode, symptom length at intake, initial symptom severity, psychotic and endogenous features emerged as significant predictors of depression outcome in univariate analyses.

Hypertension in acute ischaemic stroke: to treat or not to treat.

The reasons for not treating hypertension could be the risk of reducing cerebral blood flow (CBF) which may induce additional cerebral damage in the so-called ischaemic "penumbra". Hypertensive patients have altered autoregulation. A severe hypertension (over 230/120 mmHg) may lead to further damage by cerebral edema which asks for antihypertensive therapy.

"Spontaneous" recovery in aphasics after single ischaemic stroke.

In a homogeneous group of 75 aphasics after single ischaemic stroke, randomly selected, performance tests were carried out two weeks and one, three and six months post-onset. None of them were systematically treated. Both for the global performance and for repetition, naming, auditory comprehension, reading comprehension, writing under dictation as well as for the communicative value of a standard interview, "spontaneous" recovery was more marked during the first three months and obviously reduced between three and six months post-onset.

Predictors of the response to tricyclic antidepressants in major depression.

In a relatively young sample of 108 nonbipolar patients with major depressive disorder and at least moderately severe depression, the contribution of a comprehensive set of socio-demographic, psychosocial, clinical and personality trait variables toward the prediction of short-term, multidimensionally evaluated response to tricyclic antidepressants was investigated by univariate and multivariate analyses. There is a naturalistic study without a standard treatment protocol, but treatment type, duration and dosage were controlled. Only patients who received at least moderate dosages of tricyclic antidepressants for minimum four weeks were included in this study.

Carbohydrate metabolism, as reflected by glycosylated hemoglobin, in clinically active definite multiple sclerosis.

In 30 patients with the diagnosis of definite multiple sclerosis (MS) established on clinical criteria (CDMS-A1 patients), who were in a severe clinical state of MS, i.e., in whom one or more MS clinical signs or symptoms had become obvious during the last 10 days, the integrated concentration of plasma glucose over long-term (the last 6-8 weeks) was established by measurement of the percent of the glycosylated fraction of hemoglobin (Hb A1).

Terminal complement complex in blood of patients with neurological diseases.

The local involvement of complement (C) in the pathophysiology of tissue lesions in several neurological diseases is known, but it has never been studied whether or not in neurological disorders the C activity in the circulation is altered as well. This was the aim of the present investigations. We measured in blood plasma, with an automatic device for analysis and quantitation of the haemolytic activity of the terminal complement complex, the variables T1, T2 and T3 which define the latter quantitatively.

Statistical study of lethal stroke.

Deceased cases with cerebral infarction and hemorrhage constituted the subjects of the present study. They were divided into two groups: 127 cases in group 1 (1954-1959) and 427 cases in group 2 (1977-1982). The purpose of the study was to compare clinical data to evidence any statistical difference between groups.

Calcium blockers in ischemic stroke.

The study investigated the evolution of 72-nifedipine treated cases with ischemic stroke. Dipyridamole was administered to 72 controls. Subjects showed clinical improvement, thus calcium blockers can constitute a therapy alternative.

Pseudotumor cerebri: risk factors, clinical course, prognostic criteria.

Unlabelled: Eighty-five patients with the diagnosis of pseudotumor cerebri were retro- and prospectively studied. For clinical evaluation, the following criteria were used: neurological--headache, ophthalmological--visual acuity, visual field, ophthalmoscopy and psychic--memory. Each patient was assigned 2 categories of results expressed by: neuropsychic and ophthalmological scores which were statistically processed.

Mapping of VEPs and ERG responses to punctual stimulations in the visual field.

Visual field projection maps were obtained using retinal and cortical EP amplitude values. Single meridian investigations were also performed. Stimulation was done with punctual photic stimuli delivered by the LED perimeter built for the purpose.

Early prognosis of survival or death after a recent stroke by blood levels of acute-phase proteins.

From 129 patients with a recent stroke 105 survived and 24 died within 3 weeks from stroke-onset. At around 40 hours after the latter, the blood-levels of the acute-phase proteins ceruloplasmin and albumin did not forecast the death of the respective patients, but, in contradistinction, the level of fibrinogen was significantly higher in those who eventually died, than in those who survived. Therefore, a higher level of fibrinogen could be a risk-factor for death after stroke.

Depressive disorders and depressive personality traits in offspring aged 10-17 of bipolar and of normal parents.

Sixty proband children (P) of bipolar I parents and 60 control children of normal parents (C), in the age range 10-17, were investigated clinically by K-SADS-E interview and psychologically by personality inventories. In the global psychopathology rate of 63% in P children and 25% in C children, depressive disorders reached 8% in P children and 0% in C children, while depressive personality traits reached 22% in P children and 15% in C children. Cluster analysis evidenced a variety of personality structures, but 3 clusters were striking: a cluster characterized by high anxiety and depressive reactivity (17% P and 5% C children), a cluster characterized by high depressive reactivity and emotional instability (5% P children), and a hyperthymic cluster (5 % P children).

Adolescent offspring of endogenous unipolar depressive parents and of normal parents.

Ninety-six children aged 10-17 of unipolar endogenous depressive proband parents and 96 matched control children of well parents were investigated using DSM-IIIR diagnostic criteria. Both sets of parents were also studied. Although the rate of psychopathology was significantly higher in proband than in control children, adaptive functioning as a measure of the severity of the psychopathology did not differentiate the two groups of children.

Psychomotor functioning in unipolar and bipolar affective disorders.

The performances of unipolar and bipolar depressive patients and also of a control group on motor, verbal and mental components of psychomotor functioning were clinically and psychometrically evaluated and compared at a univariate and multivariate level. The groups were similar with respect to age, sex, educational level, illness onset age and depression severity. In univariate comparisons of test-based assessments of psychomotor functions the overall tendency was towards a more pronounced retardation in unipolar depressive patients compared to bipolar ones and controls, the differences being marked on some measures and relatively small on others.

Acute-phase proteins in stroke: influences of its cause (cerebral hemorrhage or infarction), of the cerebral site of infarction, and of the sex of patients.

In most of the 129 patients with a recent stroke by cerebral hemorrhage or infarction a note-worthy acute-phase response was found, as demonstrated by important quantitative alterations of blood levels of several acute-phase proteins (APP). These alterations were different in patients with cerebral hemorrhage as compared to those with cerebral infarction. The alterations due to cerebral infarction were not different according to the site of the infarction in brain, i.

Catamnestic study of cases with tardive decompensated hydrocephalus.

One hundred patients with decompensated hydrocephalus (60 operated, 40 nonoperated) were studied both retrospectively and prospectively at 3 moments of the disease course. The indicators were clinical: neurologic, psychic and social, and paraclinical: results of pneumoencephalography, encephalography, radioisotope cisternography. The effects of surgical treatment (ventriculocardiac derivation) and of medical treatment were evaluated at short and long term.

Use of word- or short-syntagma-stimulation for utterance production in aphasics.

In 50 aphasics and 30 normal controls, a therapeutic stimulating technique using different classes of words and short syntagmas was performed. The different classes of words or short syntagmas elicited different types of answers. Unlike controls, the aphasics showed a tendency to less often include the stimulus in the answer and to substitute it inadequately.

Contribution of EEG mapping to diagnosis setting in a supratentorial damage.

Forty neurologic patients were investigated in order to disclose the diagnostic advantages by power ratio EEG mapping. Typical examples of EEG maps in brain tumours, cerebral infarction, encephalitis and epilepsy are given. In spite of obvious limitations, the necessity of EEG mapping utilization in the neurological clinic is supported.

Children aged 10-17 of endogenous unipolar depressive parents and of normal parents. I. Psychopathology rate and relationship of the severity of the psychopathology to familial and environmental variables.

Seventy two children aged 10-17 of 42 endogenous unipolar depressive parents (proband children) and 72 children aged 10-17 of 66 normal parental couples (control children) were studied. Overall rate of psychopathology (disorders present at the time of investigation and one year before) reached 51% in proband children and 29% in control children. Depressive disorder rate reached 10% in proband children and 4% in control children.