ABSTRACT
We evaluated the quantitative myasthenia gravis score to determine which items better discriminate among patients and are most responsive to treatment. Current scoring ranges were compared to updated normative data when appropriate. Data from a previous study of intravenous immunoglobulin versus placebo in myasthenia gravis were analyzed. Each item of the quantitative myasthenia gravis score was analyzed for distribution, responsiveness and inter-item correlations. Items on swallowing, speaking and vital capacity had marked floor effects as did grip strength based on current normative data. The timed measures were responsive to treatment but diplopia, vital capacity and grip strength were not. Ocular items were not correlated with bulbar and generalized items (p>0.05), suggesting multi-dimensionality. Contralateral arm and leg tests were highly correlated (r>0.9, p<0.001), indicating redundancy. In summary, we found that the bulbar items and grip strength did not perform well. Timed items from the Quantitative Myasthenia Gravis Score, representing fatigability, are responsive to change and we propose new ranges based on updated normative data.
Subject(s)
Diplopia/therapy , Myasthenia Gravis/therapy , Adult , Aged , Female , Humans , Immunoglobulins, Intravenous/therapeutic use , Male , Middle Aged , Myasthenia Gravis/diagnosis , Outcome Assessment, Health Care , Reproducibility of ResultsABSTRACT
Background: Stroke is the second cause of mortality and the first cause of morbidity in Chile and worldwide. Nowadays there is a major interest in introducing new therapies applying evidence based medicine for these patients. Aim: To describe the clinical profile of patients attended after a stroke, to determine stroke subtypes and their risk factors. Material and methods: Retrospective review of clinical records of 459 patients (mean age 65±48 years, 238 female) that were admitted to our unit during a period of 37 months. Results: Sixty three percent of patients had an ischemic stroke, 14% had an hemorrhagic stroke, 15% had a transient ischemic attack, 2% had a cerebral venous thrombosis and 6% a subarachnoidal hemorrhage. The global mortality was 1%. Seventy percent of patients had a history of high blood pressure. Conclusions: The most common type of stroke is ischemic and high blood pressure is the main risk factor.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Stroke/epidemiology , Hospital Units/statistics & numerical data , Age Distribution , Stroke/classification , Stroke/etiology , Chi-Square Distribution , Chile/epidemiology , Diabetes Complications , Hypertension/complications , Retrospective Studies , Risk Factors , Sex DistributionABSTRACT
BACKGROUND: Stroke is the second cause of mortality and the first cause of morbidity in Chile and worldwide. Nowadays there is a major interest in introducing new therapies applying evidence based medicine for these patients. AIM: To describe the clinical profile of patients attended after a stroke, to determine stroke subtypes and their risk factors. MATERIAL AND METHODS: Retrospective review of clinical records of 459 patients (mean age 65+/-48 years, 238 female) that were admitted to our unit during a period of 37 months. RESULTS: Sixty three percent of patients had an ischemic stroke, 14% had an hemorrhagic stroke, 15% had a transient ischemic attack, 2% had a cerebral venous thrombosis and 6% a subarachnoidal hemorrhage. The global mortality was 1%. Seventy percent of patients had a history of high blood pressure. CONCLUSIONS: The most common type of stroke is ischemic and high blood pressure is the main risk factor.
