The effects of literacy and education on the quantitative and qualitative aspects of semantic verbal fluency.

Semantic verbal fluency tasks are commonly used in neuropsychological assessment. Investigations of the influence of level of literacy have not yielded consistent results in the literature. This prompted us to investigate the ecological relevance of task specifics, in particular, the choice of semantic criteria used. Two groups of literate and illiterate subjects were compared on two verbal fluency tasks using different semantic criteria. The performance on a food criterion (supermarket fluency task), considered more ecologically relevant for the two literacy groups, and an animal criterion (animal fluency task) were compared. The data were analysed using both quantitative and qualitative measures. The quantitative analysis indicated that the two literacy groups performed equally well on the supermarket fluency task. In contrast, results differed significantly during the animal fluency task. The qualitative analyses indicated differences between groups related to the strategies used, especially with respect to the animal fluency task. The overall results suggest that there is not a substantial difference between literate and illiterate subjects related to the fundamental workings of semantic memory. However, there is indication that the content of semantic memory reflects differences in shared cultural background--in other words, formal education--, as indicated by the significant interaction between level of literacy and semantic criterion.     

Chicken's valve in a human heart

A 73-year-old woman was studied after admission for anteriorwall ST-segment elevation myocardial infarction. Transthoracicechocardiography (GE Vingmed, Vivid 7, Horten, Norway)     

Intravenous drug abuse and Type 1 diabetes: financial and healthcare implications.

AIMS: To determine the morbidity, mortality and healthcare costs of intravenous drug-abusing patients with Type 1 diabetes (IVDA-DM), who are admitted to hospital. METHODS: Retrospective case note analysis of admissions, complications and cost estimation over a 6-year period. Each drug-abusing patient (IVDA-DM) (n = 9) was compared with two controls (n = 18) with Type 1 diabetes but without a history of intravenous drug abuse (DM-controls). Admissions were also analysed for patients with intravenous drug abuse, but without Type 1 diabetes (IVDA-controls) (n = 198). Admissions were at a University teaching hospital in Liverpool, UK. DM-controls were drawn from a population attending diabetes outpatient clinics between 1997 and 2002 at the same hospital. The main outcome measures were: the duration and healthcare costs of hospital admissions per year, outpatient attendances per year, glycated haemoglobin (HbA(1c)), weight, micro- and macrovascular complications and mortality. RESULTS: Multiple admissions, mainly related to ketoacidosis, led to marked differences in mean (95% CI) inpatient days per year per patient [IVDA-DM 28.1 (13.6-42.7) vs. DM-control 1.1 (0.2-1.9); P < 0.0001], mean inpatient days per year per patient in critical care bed (IVDA-DM 1.7 (-0.7-4.2) vs. DM-control 0; P < 0.02) and mean costs of admission, per patient per year (pound sterling 7320 vs. pound sterling 230). The IVDA-DM group frequently omitted insulin, were underweight, failed to attend as outpatients and five had died by the end of 2002. The IVDA-controls spent considerably less time in hospital [3.4 (2.8-3.9) days per patient per year]. CONCLUSION: IVDA-DM patients have higher rates of diabetes complications, are admitted more frequently and have a high mortality compared with DM and IVDA-controls. The cost of inpatient care of this small group of patients was considerable.     

Effect of bite tray impression technique on relocation accuracy in frameless stereotactic radiotherapy.

A previously developed method for achieving patient relocation in fractionated stereotactic radiotherapy (attachment of an infrared fiducial system to a bite tray) relies on the integrity of a bite tray system that incorporates moulding to the patient's upper dentition. Reproducible and accurate patient positioning requires stability of the bite tray and mould during the full treatment process, both during the time the bite tray is inserted in the patient's mouth, and between separate bite tray insertions. The optimum construction method for a stable reproducible tray has not been sufficiently investigated. We undertook a study to identify factors which might influence the integrity of the hard palate bite tray system. Reprosil Fast Set Putty was used to construct 3 impression conditions; teeth only; teeth and alveolar sulcus; and teeth, alveolar sulcus, and the hard palate. Reproducibility was assessed by volunteers inserting the impressions multiple times and recording the locations of 8 standard reference points. Our results showed the optimal impression technique (i.e., the one that led to the smallest ranges in positional and rotational errors) was that which incorporated the teeth, alveolar sulcus, and hard palate.     

Brain tissue microarrays in dementia research: White matter microvascular pathology in Alzheimer's disease

Tissue microarrays (TMA) consist of up to 1000 cylindrical tissue cores from different donor paraffin blocks relocated into one recipient block, allowing for efficient histopathological studies by fluorescence in situ hybridization, RNA in situ hybridization or immunohistochemistry. On the background of the increasing interest of the TMA technique in cancer research and the suggestion of its application also in studies of non‐neoplastic intracranial disorders, the technique was applied to pathologic white matter in AD brains. Eight cases with AD and concomitant white matter pathology were neuropathologically diagnosed on whole brain coronal slides. The TMA technique was used to grade severity of white matter pathology and to quantify small vessels with traditional staining and immunohistochemical markers. These measurements were compared with the whole brain neuropathological assessment. The technique produced good results with preserved tissue structures as confirmed by the whole brain evaluation. Severity of white matter pathology evaluated on the TMA cores correlated negatively with small vessel quantities, and statistically significant differences in vessel quantities paralleled different grades of white matter pathology. It is concluded that the TMA technique could be further utilized in studies of dementing disorders, and may have its advantages in large, clinically well‐characterized materials (e.g. in quantitative mapping of white matter changes).