Measuring vocabulary by free expression and recognition tasks: Implications for assessing children, adolescents, and young adults

Vocabulary tests are commonly used for assessing verbal ability. Most vocabulary tests employ the free expressive format that taps both verbal knowledge and expressive ability. The recognition format, which requires less expressive ability, has been suggested to be more sensitive in assessing the fund of verbal knowledge. We assessed vocabulary performance of 285 normal individuals (aged 6 to 23 years) using both free expressive and recognition tasks. Results showed that participants aged 6 to 15 performed significantly better on the recognition than on the free expressive task. While the recognition task significantly correlated with the Test of Nonverbal Intelligence-Third Edition (TONI-III) IQ for individuals aged 9 and above, the free expressive task correlated with TONI-III IQ only for young adults. Shortened 18-item versions yielded high reliability and correlation with the full version and reliable association with TONI-III IQ. These results highlight the utility of recognition tasks in measuring the fund of knowledge and suggest the possibility of developing shorter vocabulary tests for more cost-effective assessment.     

Sorl1 as an Alzheimer's disease predisposition gene?

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressively disabling impairments in memory, cognition, and non-cognitive behavioural symptoms. Sporadic AD is multifactorial and genetically complex. While several monogenic mutations cause early-onset AD and gene alleles have been suggested as AD susceptibility factors, the only extensively validated susceptibility gene for late-onset AD is the apolipoprotein E (APOE) epsilon4 allele. Alleles of the APOE gene do not account for all of the genetic load calculated to be responsible for AD predisposition. Recently, polymorphisms across the neuronal sortilin-related receptor (SORL1) gene were shown to be significantly associated with AD in several cohorts. Here we present the results of our large case-control whole-genome scan at over 500,000 polymorphisms which presents weak evidence for association and potentially narrows the association interval.     

Laparoscopic colorectal resection does not reduce incisional hernia rates when compared with open colorectal resection

Background Laparoscopic colorectal surgery has been reported to have some advantages compared with open surgery. The purpose of this study was to evaluate the incidence of incisional hernias after elective open colorectal resection versus laparoscopic colorectal resection. Methods The study group consisted of 104 patients who underwent elective colorectal resection or reversal of a Hartmann’s procedure between November 2003 and March 2005. Baseline data were prospectively recorded on all patients. All were examined by an independent observer for evidence of incisional hernia after they had reached a minimum follow up of one year. Results At a median follow up of 22 (17–26) months, nine patients had died and 95 were reviewed. Of these, 32 underwent laparoscopic resection while 63 had open surgery. Patients were well matched for all baseline characteristics. The median length of the wound in the laparoscopic group was 9 cm (IQR: 8–11 cm) while in the open group it was 20.8 cm (IQR: 17–24 cm). There was no significant difference in incisional hernia rates between the groups (3 vs. 10, p = 0.52) or in those who had symptoms from their hernia (p = 0.773). Conclusions Laparoscopic colorectal resection does not appear to reduce incisional hernia rates when compared with open surgery. Large randomised trials are required to confirm these findings.     

Arthroscopic hemitrapeziectomy with tendon interposition for arthritis at the first carpometacarpal joint

The first carpometacarpal (CMC) joint, also referred to as trapeziometacarpal joint, is the area of the hand most commonly symptomatic of osteoarthritis. Although there are a variety of surgical techniques that treat this condition, this article focuses on the technical aspects of arthroscopic hemitrapeziectomy with tendon interposition. Furthermore, this study evaluated the use of arthroscopy to treat CMC arthritis, with the expectation that an arthroscopic procedure would lead to low morbidity, quick recovery of function, rapid resolution of pain, and satisfactory results in patients' strength, range of motion, and pain relief. Early outcomes data indicate that all patients experienced statistically significant improvement in their pain scale rating at a mean of 11 months after the operation. All patients were satisfied with the outcome of their surgery. All patients would choose to have this surgery again. This study supports arthroscopic hemitrapeziectomy with tendon interposition as a safe and effective treatment for CMC arthritis.     

The use of enteric-coated mycophenolate sodium in the treatment of relapsing and steroid-dependent minimal change disease

We report on the successful treatment of 5 consecutive adult patients with steroid-dependent or frequently relapsing minimal change disease (MCD), using a regimen of enteric-coated mycophenolate sodium (E-MPS) and prednisolone. E-MPS was used for induction therapy in 3 patients, and maintenance therapy in 2, all in conjunction with steroid treatment in tapering doses. Eventually 4 patients managed to discontinue steroid treatment, and 2 of them were also withdrawn from E-MPS. This combination therapy resulted in sustained remission and was well tolerated by our patients, with no signs of gastrointestinal upset, marrow suppression or increased incidence of infections. Our preliminary experience suggests that E-MPS is a promising new alternative in the management of steroid-dependent and relapsing MCD with a possibility of improving gastrointestinal tolerance.     

Clinical correlates of the caregiving experience for Chinese caregivers of patients with schizophrenia

OBJECTIVE: To assess the correlation between clinical characteristics and the caregiving experience of caregivers of patients with schizophrenia. PATIENTS AND METHODS: Two hundred and one patients with schizophrenia and their caregivers were recruited from a psychiatric clinic. The involvement evaluation questionnaire (IEQ) and the general health questionnaire (GHQ) were administered to the caregivers. The patients were assessed by the Structured Clinical Interview, the positive and negative syndrome scale (PANSS) and the global assessment of functioning scale (GAF). Correlation analysis and regression analysis was performed to identify the best predictors of caregiver stress. RESULTS: The most important clinical predictor of caregiver stress as assessed using IEQ was the GAF, followed by PANSS-Pos and Neg scores and admission. Positive symptoms contributed more to overall caregiver stress than negative symptoms. DISCUSSION: Both symptom severity and patient function were important factors in the caregiver experience. Treatment should aim not only to reduce symptoms but also maximize function. Service planning should include psychosocial intervention involving caregivers.     

Lower risk of tuberculosis in obesity

BACKGROUND: Obesity is increasingly prevalent in both developed and developing areas. Although undernutrition is well associated with tuberculosis, few studies have systematically examined the association with obesity. Method A cohort of 42 116 individuals 65 years or older enrolled at 18 health centers for elderly patients in Hong Kong, China (which has a tuberculosis incidence of approximately 90 per 100,000 population), in 2000 were followed up prospectively through the territory-wide tuberculosis registry for the development of active tuberculosis from 3 months after enrollment until December 31, 2005, using the identity card number as the unique identifier. The association with body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters), as categorized by the Asian standards, was assessed with the control of other baseline characteristics. RESULTS: Obese (BMI>or=30) and overweight (BMI, 25 to <30) individuals were at significantly lower risks of developing active tuberculosis than normal-weight individuals (BMI, 18.5 to <25), with hazard ratios (95% confidence intervals) of 0.36 (0.20-0.66) and 0.55 (0.44-0.70), respectively, after adjustment for baseline demographic, social, and clinical variables. An inverse linear association was observed predominantly for pulmonary but not extrapulmonary tuberculosis. This association persisted after controlling for potential confounders or excluding individuals with known tuberculosis risk factors. CONCLUSIONS: Obesity is associated with a lower risk of active pulmonary tuberculosis in the older population of Hong Kong. The presence of such a strong but selective association across the whole spectrum of BMI could have major biological, clinical, and/or epidemiological implications. Further studies are indicated to explore the underlying mechanisms, potential clinical utilities, and possible epidemiological consequences.     

Adjuvant chemoradiation for gastric cancer: experience in the Chinese population

AimsThe role of adjuvant chemoradiation for gastric cancer after curative R0 gastrectomy was first established by the US Intergroup 0116 study. Although confirmatory studies are in progress, few data are available regarding its application to the Chinese population. We describe our radiotherapy technique and report the treatment results in Hong Kong.Materials and methodsThis was a single centre retrospective study on 63 Chinese patients who underwent adjuvant chemoradiation for gastric adenocarcinoma between June 2000 and December 2004. The treatment protocol was based on that of the Intergroup study. Computed tomography planned anteroposterior opposing field arrangement and treatment under breath hold at deep inspiration position were adopted.ResultsIn total, 63 patients, mean age 50 years, with gastric cancer stage IB to limited metastatic IV disease were analysed. The median follow-up time was 27.2 months. The relapse-free survival and overall survival at 3 years were 50 and 54%, respectively. The recurrence pattern was dominated by distant failure and only one patient developed isolated locoregional recurrence. Of the 10 patients who had positive microscopic surgical margins after surgery, seven had recurred and died. On multivariate analysis, margin status was the only significant prognosticator for survival. Thirty per cent of patients experienced grade 3 or above acute toxicity (24% haematological, 14% gastrointestinal) and one patient died of neutropenic sepsis. There was one case of grade 3 late toxicity.ConclusionsThe outcome after adjuvant chemoradiation for gastric cancer seemed to be favourable, with manageable toxicities, in the Chinese population. Locoregional failure was uncommon. Patients with microscopic surgical margin involvement had a very high failure rate despite adjuvant chemoradiation.