Transcranial magnetic stimulation of left auditory cortex in patients with schizophrenia: effects on hallucinations and neurocognition

The effects of transcranial magnetic stimulation (TMS) on hallucination severity and neurocognition were studied in 9 medication-resistant hallucinating patients. A statistically significant improvement was observed on a hallucination scale after 10 days of TMS at the left auditory cortex.     

Coordinate and categorical judgements in spatial imagery. An fMRI study

We aimed at verifying whether the hemispheric specialisation for categorical/coordinate spatial judgements also applies to the spatial imagery domain by the use of whole-brain fMRI. In a block-design experiment we used the "coordinate" mental clock test, contrasting it with a "categorical" task applied to the same clock stimuli; as a control task we used a syllable counting task requiring a verbal-phonological judgement on the same material of the two imagery tasks. Our results showed that categorical and coordinate spatial judgements on imagined stimuli rely on the activation of a set of cortical areas, centred upon the superior parietal lobule (SPL) bilaterally. These regions, together with other parietal and prefrontal areas, showed a pattern of relative lateralization, with the left hemisphere being mainly activated during the categorical task and the right in the coordinate task. These data confirm the strong involvement of the SPL in spatial processing. Moreover, our findings suggest that different interconnected neural networks are activated to comply with specific test requirements, giving rise to functional imaging patterns compatible with psychological theories on hemispheric specialization.     

Cognitive impairment in depressed outpatients as measured with the Dementia Checklist: a simple method for primary care and in field research

The Dementia Checklist is a 12-item dementia rating scale for physicians who, for whatever reason, cannot be specifically trained. It addresses symptoms of cognitive decline that can easily be identified, and that are typical for different stages of cognitive impairment. This allows an easy classification of the severity of dementia. In a first study, the dementia checklist was used in 937 geriatric outpatients who were treated by neuropsychiatrists for depression. All items contribute to the accuracy of measurement (Cronbach's alpha = 0.84). Differences in cognitive impairment depending on age (chi 2 = 51.7; p < or = 0.001) and depression (chi 2 = 47.6; p < or = 0.001) indicate external validity of the dementia checklist and 5.7% of the outpatients were rated as demented. The Dementia Checklist provides a very economical and easy-to-use assessment of cognitive decline.     

The physical properties of conventional and resin-modified glass-ionomer dental cements stored in saliva,proprietary acidic beverages,saline and water

Specimens of three conventional and one resin-modified glass-ionomer cement were prepared for both compressive strength and biaxial flexure strength determination. They were stored either in neutral media (water, saline, unstimulated whole saliva or stimulated parotid saliva) or in acidic beverages (apple juice, orange juice or Coca-Cola) for time periods ranging from 1 day to 1 year. In neutral media, the compressive and biaxial flexural strengths of all cements studied showed similar results, with significant increases apparent in compressive strengths at 6 months and which continued to 1 year, but no significant differences between the media; and no significant differences with time for biaxial flexure strength in all media. These findings show that interactions of these cements with saliva, which are known to result in deposition of calcium and phosphate, do not affect strength. Results for specimens stored in Coca-Cola were the same as for those stored in neutral media. By contrast, in orange and apple juice specimens underwent severe erosion resulting in dissolution of the conventional glass-ionomers after 3-6 months, and/or significant loss of strength at 1-3 months. Erosion of the resin-modified glass-ionomer, Vitremer, led to a significant reduction in strength, but not in dissolution, even after 12 months. The chelating carboxylic acids in these fruit juices were assumed to be responsible for these effects.     

Initiation of biological agents in patients with ankylosing spondylitis: results of a Delphi study by the ASAS Group

BACKGROUND: There is ample evidence of important symptomatic efficacy of tumour necrosis factor alpha (TNFalpha) inhibition in ankylosing spondylitis (AS). Moreover, studies suggest that anti-TNF could be considered as the first disease controlling antirheumatic treatment (DC-ART) for AS. OBJECTIVE: To determine precisely which patients with AS are most likely to benefit from anti-TNFalpha treatment because of the cost and possible long term side effects of such treatment. METHODS: Assessment in Ankylosing Spondylitis (ASAS) members were asked to use a Delphi technique to name the characteristics of patients with AS for whom they would start DC-ART, in three different clinical presentations (isolated axial involvement, peripheral arthritis, enthesitis). RESULTS: Among the 62 invited ASAS members, more than 50% actively participated in the four phases of definition according to the Delphi technique. For each of the three clinical presentations, a combination of five to six domains was proposed, with an evaluation instrument and a cut off point defining a minimum level of activity for each domain. CONCLUSION: This study provides a profile for a patient with AS for considering initiation of biological agents that reflects the opinion of the ASAS members, using a Delphi exercise. Further studies are required to assess their relevance and their consistency with clinical practice.