The influence of different error estimates in the detection of postoperative cognitive dysfunction using reliable change indices with correction for practice effects.

The reliable change index (RCI) expresses change relative to its associated error, and is useful in the identification of postoperative cognitive dysfunction (POCD). This paper examines four common RCIs that each account for error in different ways. Three rules incorporate a constant correction for practice effects and are contrasted with the standard RCI that had no correction for practice. These rules are applied to 160 patients undergoing coronary artery bypass graft (CABG) surgery who completed neuropsychological assessments preoperatively and 1 week postoperatively using error and reliability data from a comparable healthy nonsurgical control group. The rules all identify POCD in a similar proportion of patients, but the use of the within-subject standard deviation (WSD), expressing the effects of random error, as an error estimate is a theoretically appropriate denominator when a constant error correction, removing the effects of systematic error, is deducted from the numerator in a RCI.     

Spatial and temporal processing in patients with Turner's syndrome

Thirteen females with Turner's syndrome were examined for spatial abilities and serial processing, and their performance was compared with that of normal females matched by age, intelligence, and socioeconomic class. Patients with Turner's syndrome performed significantly poorer on tests of spatial ability than controls, but only on spatial tests requiring the integration of isolated elements as synthetic wholes or the remembering of spatial configurations which could not be verbally mediated. Patients also performed less well than controls on tasks of serial processing when the tasks could not be mediated verbally. It was concluded that patients with Turner's syndrome may have a selective deficit in cortical junctions that are lateralized to the right cerebral hemisphere.The work for this study was performed while the authors were supported by a grant from the Grant Foundation, and while P. H. W. was supported by USPHS Research Grants MH 18332-04 and HD 03 0773 and by USPHS Career Scientist Award MHK 3461.     

Glenoid labrum: preliminary work with use of radial-sequence MR imaging

The authors describe a magnetic resonance imaging method for examination of the glenoid labrum of the shoulder joint that utilizes a radial fast-imaging sequence. Seven shoulders were examined: a total of five in three healthy asymptomatic volunteers, one in a symptomatic patient not suspected of having a lesion of the glenoid labrum, and one in a patient with recurrent shoulder dislocation and surgical proof of an extensive tear of the labrum. The preliminary results suggest that this technique may advantageously demonstrate pathologic changes in the glenoid labrum and may contribute to the evaluation of the unstable and painful shoulder.     

Death in childhood due to facio-scapulo-humeral dystrophy

ABSTRACT Two siblings with facio-scapulo-humeral dystrophy (FSH) had muscle biopsy with light microscopy and histochemistry performed. Rapid disease progression resulted in the death of one child at age 5 years. Such an outcome has not been previously reported.