A 28-year-old man with chronic hydrocephalus d u e to aqueductal stenosis was found to have a sub... more A 28-year-old man with chronic hydrocephalus d u e to aqueductal stenosis was found to have a subnormal response of growth hormone to arginine infusion. It is postulated that compression of the pituitary by t h e enlarged third ventricle produced a deficiency of g r o w t h hormone and short stature.
We studied the influence of leukoaraiosis on the prognosis of stroke for the first year after ons... more We studied the influence of leukoaraiosis on the prognosis of stroke for the first year after onset. Three hundred and seventy consecutive stroke subjects were observed for 1 year. Data were collected prospectively in a questionnaire constructed in accordance with the Stroke Data Bank and analyzed using SPSS. Leukoaraiosis was observed in 17.6% of subjects. Subjects with leukoaraiosis were older than subjects without leukoaraiosis. Cerebrovascular risk factors were similar in both groups. During the first 30 days, the fatality rate of both groups was similar. However, at 1 year, the fatality rate in subjects with leukoaraiosis was higher. Stroke Severity, Weakness Score, and the Barthel Modified Activities for Daily Living score did not differ between groups at 30 days or 1 year. At both 30 days and 1 year, the MMSE score was lower in subjects with leukoaraiosis. Leukoaraiosis did not predict stroke recurrence within 1 year. Leukoaraiosis in stroke patients is an adverse predictor of cognitive functioning at 30 days and at 1 year and is an adverse predictor of survival at 1 year.
We studied insight into illness in 41 patients with probable Alzheimer's disease. An impaired ins... more We studied insight into illness in 41 patients with probable Alzheimer's disease. An impaired insight score was developed by measuring discrepancies between patient report and caregiver report on standard instruments of activities of daily living. Insight was more impaired in subjects with greater dementia severity and subjects with paranoid delusions. In a multivariate analysis, the best neuropsychological predictors of impaired insight were the Continuous Performance Test and the Visual Reproduction Test. We speculate that the impaired insight of Alzheimer's disease has two components: confabulation reflecting prefrontal dysfunction and anosognosia reflecting right-hemisphere dysfunction. (J Geriatr Psychi
We report two women with Sanfilippo syndrome. Both had characteristic aggressiveness that was ref... more We report two women with Sanfilippo syndrome. Both had characteristic aggressiveness that was refractory to treatment with conventional agents. Both women improved on oral estrogen therapy and showed diminished aggressiveness. [Neurol Res 1999; 21 : 611-612]
Poland has high mortality and morbidity due to stroke. Our prospective population based study con... more Poland has high mortality and morbidity due to stroke. Our prospective population based study conducted in Warsaw in 1991-1992 showed a stroke incidence similar to other European countries. However, 3D-day case mortality rates were much higher. Our aim was to explore factors predicting 3D-day mortality in War-saw. The study population consisted of all patients with first-ever-in-a-lifetime strokes admitted to the Department of Cerebrovascular Diseases during the 2-year prospective population-based stroke registry. Cases with uncertain stroke type were excluded from analysis. During the 2-year study period, 633 patients with stroke were registered (462 with first-ever-in-a-lifetime stroke); 351 of them completed full diagnostic procedures, and 297 were diagnosed with ischemic stroke (IS) and 54 with intracerebral hemorrhage (ICH). A logistic regression model for IS identified 7 independent variables predicting 3D-day mortality: increasing age, decreased consciousness at the onset of stroke, extraocular movement disorder, severity of motor weakness, congestive heart failure, kidney diseases , and chronic obstructive pulmonary diseases (COPD). A logistic regression model for ICH identified two independent predictor variables: extraocular movement disorders and decreased consciousness. Comparison of the Warsaw Stroke Registry with the Stroke Data Bank (SDB) revealed higher prevalences of heart disease (angina and atrial fibrillation) and COPD in the Warsaw population. Co-morbidity of medical diseases with stroke probably contributed to higher mortality in the Warsaw as opposed to U.S. patient sample. Disorders of consciousness at the onset of stroke were more severe in Warsaw than in the U.S. sample. Stroke type, severity of weakness score, and severity of stroke scale were similar for the SDB and Warsaw populations. In Poland, high levels of medical comor-bidity rather than stroke severity probably account for poor short-term prognosis in stroke. Stroke is the third leading cause of death in adults. Many stroke-related deaths occur shortly after the onset of symptoms. In many countries, mortality and morbidity due to stroke have decreased (1). Available data suggest a 3D-day mortality ranging from 9.8% to 22.7% for ischemic stroke and from 37.8% to 50% for hemorrhagic stroke (2-4). In Poland the epidemic
Journal of Autism and Developmental Disorders, 1979
Utilizing computerized brain tomography, left-right morphologic asymmetries of the parietooccipit... more Utilizing computerized brain tomography, left-right morphologic asymmetries of the parietooccipital region were judged in 16 autistic patients, 44 mentally retarded patients, and 100 miscellaneous neurological patients. In 57% of the autistic patients the right parietooccipital region was wider than the left, while this pattern of cerebral asymmetry was found in only 23% of the mentally retarded patients and 25% of the neurological patients. It is suggested that unfavorable morphologic asymmetries of the brain near the posterior language zone may contribute to the difficulties autistic children experience in acquiring language.
In a group of 53 children and young adults with learning disability, reversed cerebral asymmetry ... more In a group of 53 children and young adults with learning disability, reversed cerebral asymmetry as measured by CT scan correlated highly with the prevalence, and to some extent with the degree, of verbal intellectual deficit as measured by age-appropriate Weschler Intelligence Scales. A history of delayed speech also correlated with reversed asymmetry but was not associated with a greater degree of verbal intellectual deficit among the reversed-asymmetry cases.
Journal of Stroke & Cerebrovascular Diseases, 1994
... Association Analysis of 30-Day Stroke Mortality in a Community-Based Registry in Warsaw, Pola... more ... Association Analysis of 30-Day Stroke Mortality in a Community-Based Registry in Warsaw, Poland 'Thomas Weissbein, MD, 'Anna Czlonkowska, MD ... Bonita R, Beaglehole R, North J. Event, incidence and case fatality rates of cerebrovascular disease in Auckland, New Zealand. ...
We conducted an online survey to assess the knowledge, attitudes, and practice patterns of physic... more We conducted an online survey to assess the knowledge, attitudes, and practice patterns of physicians related to issues in problem list documentation. Respondents felt that a decision support tool to improve problem list documentation would benefit patient safety more than physician productivity. The majority of respondents are reluctant to maintain medication and problem lists and the quality of documentation remains inadequate.
We designed and tested a clinical decision support system (CDSS) prototype to investigate whether... more We designed and tested a clinical decision support system (CDSS) prototype to investigate whether a CDSS that assists matching ordered drugs to problems on the problem list can enhance the maintenance of medications and problem lists in the electronic medical record. We evaluated the capability of this CDSS in medication-problem matching using clinical expert chart audits. The analysis revealed that this CDSS could determine the completeness of medication and problem lists if a mismatch occurs.
Studies in health technology and informatics, 2004
In order to determine whether differences exist between housestaff and faculty physician acceptan... more In order to determine whether differences exist between housestaff and faculty physician acceptance of an electronic health record system, we conducted a written survey of attitudes towards new electronic medical record at the University of Illinois at Chicago. We surveyed 330 faculty and housestaff physicians. User acceptance of the EHR was high for both faculty physicians and housestaff. 88.0% of the housestaff and 64.7% of the faculty preferred the EHR over a paper record. Although both housestaff and faculty acceptance of an EHR was high, housestaff showed greater approval ratings than faculty. Central to acceptance of an EHR is conservation of physician time including improving system speed, reducing time spent waiting for a computer to become available, and minimizing time spent documenting care
IEEE Symposium on Computer-Based Medical Systems, 1994
A treatment risk analysis system was developed and presented by the MEDAS project group. Now, a r... more A treatment risk analysis system was developed and presented by the MEDAS project group. Now, a risk analysis system for medical tests has also been developed to form a complete medical decision support system. Moreover, the current system (a combined treatment and test system) has been redesigned and developed using an object-oriented hypermedia programming language, called Spinnaker Plus, running on
A 28-year-old man with chronic hydrocephalus d u e to aqueductal stenosis was found to have a sub... more A 28-year-old man with chronic hydrocephalus d u e to aqueductal stenosis was found to have a subnormal response of growth hormone to arginine infusion. It is postulated that compression of the pituitary by t h e enlarged third ventricle produced a deficiency of g r o w t h hormone and short stature.
We studied the influence of leukoaraiosis on the prognosis of stroke for the first year after ons... more We studied the influence of leukoaraiosis on the prognosis of stroke for the first year after onset. Three hundred and seventy consecutive stroke subjects were observed for 1 year. Data were collected prospectively in a questionnaire constructed in accordance with the Stroke Data Bank and analyzed using SPSS. Leukoaraiosis was observed in 17.6% of subjects. Subjects with leukoaraiosis were older than subjects without leukoaraiosis. Cerebrovascular risk factors were similar in both groups. During the first 30 days, the fatality rate of both groups was similar. However, at 1 year, the fatality rate in subjects with leukoaraiosis was higher. Stroke Severity, Weakness Score, and the Barthel Modified Activities for Daily Living score did not differ between groups at 30 days or 1 year. At both 30 days and 1 year, the MMSE score was lower in subjects with leukoaraiosis. Leukoaraiosis did not predict stroke recurrence within 1 year. Leukoaraiosis in stroke patients is an adverse predictor of cognitive functioning at 30 days and at 1 year and is an adverse predictor of survival at 1 year.
We studied insight into illness in 41 patients with probable Alzheimer's disease. An impaired ins... more We studied insight into illness in 41 patients with probable Alzheimer's disease. An impaired insight score was developed by measuring discrepancies between patient report and caregiver report on standard instruments of activities of daily living. Insight was more impaired in subjects with greater dementia severity and subjects with paranoid delusions. In a multivariate analysis, the best neuropsychological predictors of impaired insight were the Continuous Performance Test and the Visual Reproduction Test. We speculate that the impaired insight of Alzheimer's disease has two components: confabulation reflecting prefrontal dysfunction and anosognosia reflecting right-hemisphere dysfunction. (J Geriatr Psychi
We report two women with Sanfilippo syndrome. Both had characteristic aggressiveness that was ref... more We report two women with Sanfilippo syndrome. Both had characteristic aggressiveness that was refractory to treatment with conventional agents. Both women improved on oral estrogen therapy and showed diminished aggressiveness. [Neurol Res 1999; 21 : 611-612]
Poland has high mortality and morbidity due to stroke. Our prospective population based study con... more Poland has high mortality and morbidity due to stroke. Our prospective population based study conducted in Warsaw in 1991-1992 showed a stroke incidence similar to other European countries. However, 3D-day case mortality rates were much higher. Our aim was to explore factors predicting 3D-day mortality in War-saw. The study population consisted of all patients with first-ever-in-a-lifetime strokes admitted to the Department of Cerebrovascular Diseases during the 2-year prospective population-based stroke registry. Cases with uncertain stroke type were excluded from analysis. During the 2-year study period, 633 patients with stroke were registered (462 with first-ever-in-a-lifetime stroke); 351 of them completed full diagnostic procedures, and 297 were diagnosed with ischemic stroke (IS) and 54 with intracerebral hemorrhage (ICH). A logistic regression model for IS identified 7 independent variables predicting 3D-day mortality: increasing age, decreased consciousness at the onset of stroke, extraocular movement disorder, severity of motor weakness, congestive heart failure, kidney diseases , and chronic obstructive pulmonary diseases (COPD). A logistic regression model for ICH identified two independent predictor variables: extraocular movement disorders and decreased consciousness. Comparison of the Warsaw Stroke Registry with the Stroke Data Bank (SDB) revealed higher prevalences of heart disease (angina and atrial fibrillation) and COPD in the Warsaw population. Co-morbidity of medical diseases with stroke probably contributed to higher mortality in the Warsaw as opposed to U.S. patient sample. Disorders of consciousness at the onset of stroke were more severe in Warsaw than in the U.S. sample. Stroke type, severity of weakness score, and severity of stroke scale were similar for the SDB and Warsaw populations. In Poland, high levels of medical comor-bidity rather than stroke severity probably account for poor short-term prognosis in stroke. Stroke is the third leading cause of death in adults. Many stroke-related deaths occur shortly after the onset of symptoms. In many countries, mortality and morbidity due to stroke have decreased (1). Available data suggest a 3D-day mortality ranging from 9.8% to 22.7% for ischemic stroke and from 37.8% to 50% for hemorrhagic stroke (2-4). In Poland the epidemic
Journal of Autism and Developmental Disorders, 1979
Utilizing computerized brain tomography, left-right morphologic asymmetries of the parietooccipit... more Utilizing computerized brain tomography, left-right morphologic asymmetries of the parietooccipital region were judged in 16 autistic patients, 44 mentally retarded patients, and 100 miscellaneous neurological patients. In 57% of the autistic patients the right parietooccipital region was wider than the left, while this pattern of cerebral asymmetry was found in only 23% of the mentally retarded patients and 25% of the neurological patients. It is suggested that unfavorable morphologic asymmetries of the brain near the posterior language zone may contribute to the difficulties autistic children experience in acquiring language.
In a group of 53 children and young adults with learning disability, reversed cerebral asymmetry ... more In a group of 53 children and young adults with learning disability, reversed cerebral asymmetry as measured by CT scan correlated highly with the prevalence, and to some extent with the degree, of verbal intellectual deficit as measured by age-appropriate Weschler Intelligence Scales. A history of delayed speech also correlated with reversed asymmetry but was not associated with a greater degree of verbal intellectual deficit among the reversed-asymmetry cases.
Journal of Stroke & Cerebrovascular Diseases, 1994
... Association Analysis of 30-Day Stroke Mortality in a Community-Based Registry in Warsaw, Pola... more ... Association Analysis of 30-Day Stroke Mortality in a Community-Based Registry in Warsaw, Poland 'Thomas Weissbein, MD, 'Anna Czlonkowska, MD ... Bonita R, Beaglehole R, North J. Event, incidence and case fatality rates of cerebrovascular disease in Auckland, New Zealand. ...
We conducted an online survey to assess the knowledge, attitudes, and practice patterns of physic... more We conducted an online survey to assess the knowledge, attitudes, and practice patterns of physicians related to issues in problem list documentation. Respondents felt that a decision support tool to improve problem list documentation would benefit patient safety more than physician productivity. The majority of respondents are reluctant to maintain medication and problem lists and the quality of documentation remains inadequate.
We designed and tested a clinical decision support system (CDSS) prototype to investigate whether... more We designed and tested a clinical decision support system (CDSS) prototype to investigate whether a CDSS that assists matching ordered drugs to problems on the problem list can enhance the maintenance of medications and problem lists in the electronic medical record. We evaluated the capability of this CDSS in medication-problem matching using clinical expert chart audits. The analysis revealed that this CDSS could determine the completeness of medication and problem lists if a mismatch occurs.
Studies in health technology and informatics, 2004
In order to determine whether differences exist between housestaff and faculty physician acceptan... more In order to determine whether differences exist between housestaff and faculty physician acceptance of an electronic health record system, we conducted a written survey of attitudes towards new electronic medical record at the University of Illinois at Chicago. We surveyed 330 faculty and housestaff physicians. User acceptance of the EHR was high for both faculty physicians and housestaff. 88.0% of the housestaff and 64.7% of the faculty preferred the EHR over a paper record. Although both housestaff and faculty acceptance of an EHR was high, housestaff showed greater approval ratings than faculty. Central to acceptance of an EHR is conservation of physician time including improving system speed, reducing time spent waiting for a computer to become available, and minimizing time spent documenting care
IEEE Symposium on Computer-Based Medical Systems, 1994
A treatment risk analysis system was developed and presented by the MEDAS project group. Now, a r... more A treatment risk analysis system was developed and presented by the MEDAS project group. Now, a risk analysis system for medical tests has also been developed to form a complete medical decision support system. Moreover, the current system (a combined treatment and test system) has been redesigned and developed using an object-oriented hypermedia programming language, called Spinnaker Plus, running on
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