Detecting simulation of attention deficits using reaction time tests.

The current study examined if a newly developed series of reaction time tests, the Computerized Tests of Information Processing (CTIP), were sensitive to simulation of attention deficits commonly caused by traumatic brain injury (TBI). The CTIP consists of three reaction time tests: Simple RT, Choice RT, and Semantic Search RT. These tests were administered to four groups: Control, Simulator, Mild TBI, and Severe TBI. Individuals attempting to simulate attention deficits produced longer reaction time scores, made more incorrect responses, and exhibited greater variability than cognitively-intact individuals and those with TBI. Sensitivity and specificity values were comparable or exceeded those obtained on the Test of Memory Malingering. As such, the CTIP offers considerable promise of serving as a viable malingering test that uses a distinctively different paradigm than the two-item, forced-choice procedure employed by traditional symptom validity tests.     

"Covert toxocariasis" in a child treated with low-dose diethylcarbamazine

A girl aged 2.5 years with "covert toxocariasis" was treated with low-dose diethylcarbamazine because of supposed noticeable disseminated Toxocara canis infection without ocular or visceral manifestations. There was marked blood and bone marrow eosinophilia, significant increased Toxocara canis antibody (ELISA) and immunoglobulins E, G and M, leucocytosis and an increased sedimentation rate. She had no geophagia, but often sucked small stones, probably contaminated with faeces from puppies. Symptoms were fever, inactivity, weakness, tiredness and loss of appetite. She was followed clinically and with blood samples throughout a period of three years and four months.     

Complementary medicine and older people: past research and future directions

Due to the natural aging processes, older people are particularly susceptible to a range of chronic health conditions. However, despite that research has indicated that chronic health conditions and disability act as reliable predictors of complementary/alternative medicine (CAM) use, despite research evidence that older people are significant consumers of CAM, and regardless of the potential for CAM to enhance successful aging, reduce frailty, and increase independence and quality of life in older persons, older people's use of CAM therapies remains under-researched. This paper reviews what existing research literature is there on CAM use in older age; considers rates of and potential for use, features of and barriers to use, and economic, effectiveness and safety issues. From these beginnings, outlined is a wide-ranging research agenda on CAM and older people.     

Ventriculopleural shunting used as a temporary diversion

Summary Due to the limited absorptive capacity of the pleural cavity, infants and young children are not generally ideal candidates for ventriculopleural shunts. We report using chest cavities as alternate for temporary diversion of CSF in a young child. Venous access to the cervical region could not be utilized because of scarring from previous procedures, while peritoneal access was contraindicated due to repeated pseudocyst formation. Pleural effusions were removed by thoracentesis when necessary, and the shunt catheter was changed to the opposite side of the chest when the effusions reaccumulated within one week. Utilizing the ventriculopleural shunts allowed us to temporize her non-communicating hydrocephalus for a period of one year, until a definitve CSF procedure by direct intracardiac placement of the distal catheter could be performed.     

Perceived support needs of family caregivers and implications for a telephone support service.

The purposes of this study were: to identify the perceived support needs of family caregivers of persons living with chronic illness (physical or cognitive) and receiving home-care services, and to describe the types of telephone services that would meet the expressed needs of caregivers. The qualitative design used semi-structured interviews. A total of 34 caregivers (mean age 62 years) participated in the study. The care recipients (mean age 78 years) were primarily the husband/wife or parent of the caregiver. The most commonly expressed caregiver needs were: a social life, instrumental support (e.g., respite, assistance with physical care, financial compensation), informational support, and emotional support. Most caregivers said they would use a telephone support service provided by a professional (71%) or a fellow caregiver (59%) if available. The results of this study support a pilot study and evaluation of a telephone support service for family caregivers.     

Preservation of bulk and strength in muscles affected by neurogenic lesions

Mechanisms involved in maintaining bulk and strength in partially denervated muscles of patients with neurogenic lesions are discussed. Estimation of muscle fiber hypertrophy by electrophysiological examination is possible, but it depends on the construction of sampling electrodes with precise geometry. The arrangement of muscle fibers of motor units within the muscle is discussed by analogy with the four-color map problem. An experiment to measure the twitch tensions of individual motor units in man is devised; it requires the use of microprocessor control of the stimulus and recurrent measurements of the twitch forces.