Factors Associated With Reduced Prehospital Delay Over 4 Years in Patients With Acute Ischemic Stroke or Transient Ischemic Attack Within 48 Hours of Symptom Onset

BACKGROUND: Prehospital delay is a major obstacle for successful treatment of acute stroke. We investigated the annual change of prehospital delay and related factors in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). METHODS: From prospective patient registry, demographic and clinical characteristics of patients who presented within 48 hours of symptom onset after AIS or TIA from 2005 to 2008 were analyzed. We compared the annual change of prehospital delay (time from symptom onset to hospital arrival) and the proportion of early arrival (EA-3, prehospital delay<3 h; EA-6, prehospital delay<6 h). We also investigated factors associated with prehospital delay and early arrival. RESULTS: Of 612 patients, 623 events of AIS or TIA were analyzed. The adjusted geometric mean (95% CI) of prehospital delay (hours) was 7.42 (6.07-9.06) in 2005, 8.18 (6.76-9.89) in 2006, 4.39 (3.50-5.51) in 2007, and 4.02 (3.10-5.22) in 2008 (p<0.01). The proportion of early arrival (year) was 23.6% (2005), 31% (2006), 58% (2007), 54% (2008) for EA-3 (p<0.001) and 38.8% (2005), 32.5% (2006), 51.6% (2007), 75% (2008) for EA-6 (p<0.001). Compared with 2006, the adjusted odds (95% CI) for early arrival were 1.54 (0.87-2.71) in 2005, 1.91 (1.11-3.30) in 2007, 2.29 (1.31-4.01) in 2008 for EA-3 and 1.37 (0.84-2.25) in 2005, 1.73 (1.06-2.81) in 2007, 2.03 (1.23-3.36) in 2008 for EA-6. Younger age, severe neurologic deficit, admission through emergency department, cardioembolic stroke, and TIA were also independently associated with early arrival. CONCLUSIONS: From 2005 to 2008, prehospital delay decreased and potential candidates for thrombolytic therapy increased significantly.

Eating Seizures in a Patient With Alzheimer's Disease

No abstract available.

Alcohol Related Seizures in Chronic Alcoholics / 대한간질학회지

PURPOSE: Alcohol related seizures (ARS) are common problems in community. We reviewed the clinical characteristics of ARS in chronic alcoholics and evaluated the predictors of delirium tremens and recurrence of seizures. METHODS: We thoroughly reviewed all medical records of patients with alcohol related seizures at admission and some outpatient records for follow-up data. For the patients who had been lost during follow-up, telephone interviews were performed. We described the clinical characteristics of ARS during admission and analyzed the correlation between initial findings of ARS. RESULTS: Forty eight patients with ARS were admitted and followup data were available in 33 patients by out-patient records or telephone interviews. Forty-four patients were male and the mean age was 47.4+/-10.4 years old. Nine out of 33 patients became completely abstinent after discharge. Ten out of 24 current drinkers developed recurrent seizures and 20 out of 48 patients developed delirium tremens (DT) during admission. The number of seizures and age ofpatients were significantly related with DT. Patients with much weekly- consumption of alcohol were prone to develop recurrent seizures. CONCLUSIONS:These results suggest that careful attention should be paid to the patients with older age and multiple seizures at each event about the development of DT and to the patients with much weekly-consumption of alcohol about the recurrence of seizures during follow-up.