Using recognition testing to support semantic learning in developmental amnesia

Patients with developmental amnesia (DA) have suffered hippocampal damage in infancy and subsequently shown poor episodic memory, but good semantic memory. It is not clear how patients with DA learn semantic information in the presence of episodic amnesia. However, patients with DA show good recognition memory and it is possible that semantic learning may be supported by recognition. Building on previous work, we compared two methods for supporting semantic learning in DA; recognition-learning and recall-learning. In each condition, a patient with DA (aged 8 years) was presented with semantic information in animated videos. After each presentation of a video, learning was supported by an immediate memory test. Two videos were paired with a cued recall test. Another two videos were paired with a multiple-choice test to enable recognition-based learning. The outcome measure was semantic recall performance after a short delay of 30 min and a long delay of one week. Results showed a benefit of recognition-learning compared to recall-learning on cued recall in the patient with DA (76% vs. 35%). This finding indicates that young people with severe hippocampal damage can utilize recognition to support semantic learning. This has implications for the support of school-aged children with episodic memory difficulties

Neuro-Ophthalmic Injuries With Systemic Neurologic Injury or Traumatic Brain Injury in Operation Iraqi Freedom and Operation Enduring Freedom

Background: To analyze the final visual acuity (VA) of neuro-ophthalmologic injuries (NOI) in combat ocular trauma and to study the association of NOI with systemic neurologic injury (SNI) and traumatic brain injury (TBI). Methods: The Walter Reed Ocular Trauma Database was reviewed. Inclusion criteria were any US service member and Department of Defense civilians who suffered NOI, SNI, or TBI in Operation Iraqi Freedom or Operation Enduring Freedom. The primary outcome measure was the rate of poor final VA in patients with an NOI with secondary outcome measures the rate of SNI and TBI. in patients with NOI. Results: One hundred seventy-eight (20.00%) of 890 eyes had an NOI. Optic nerve injury was observed in 79 (44.38%) eyes, other cranial nerve injury in 68 (38.20%), Horner syndrome in 4 (2.25%), diplopia in 45 (25.28%), and ptosis in 13 (7.30%). In patients with NOI, 76 (42.69%) eyes had a final VA less than 20/200. In injured eyes (n = 359) of patients (n = 251) with TBI, 154 eyes (34.26%) had a final VA less than 20/200. In multivariate analysis, optic nerve injury (P < 0.001), unlike TBI (P = 0.47), was associated with final VA less than 20/200. SNI (n = 229) had a statistically significant association (odds ratio 29.8, 95% confidence interval 19.2-47.8, P < 0.001) with NOI. Optic nerve injury and cranial nerve injury were associated with TBI and SNI (all, P < 0.001). Conclusion: Optic nerve injury and cranial nerve injury are associated with TBI and SNI. Optic nerve injury, but not TBI or cranial nerve injury, is associated with a poor final VA

Ezetimibe - A clinically effective and a cost-effective treatment option for dyslipidaemia

Although statins are first-line treatment for most patients with dyslipidaemia, some people require additional or alternative treatment to modify their lipid profile. Many patients treated with statins still fail to achieve increasingly stringent LDL-C goals in clinical practice, and can benefit from add-on ezetimibe therapy, which has a complementary mechanism of action to other drugs in current use. Many clinical studies have demonstrated that combinations of ezetimibe with statins, fibrates, and other lipid-modifying therapies, provide better normalisation of lipid profiles than these drugs given as monotherapy. Moreover, ezetimibe is also effective as a monotherapy. The safety and tolerability profile of ezetimibe as monotherapy is similar to placebo, and is also excellent when given in combination with other lipid-modifying agents. Ezetimibe may also provide a cost-effective alternative to statin titration. These findings suggest that ezetimibe represents a useful alternative and adjunct to other lipid management strategies. © 2008 CSF Medical Communications Ltd

Ezetimibe - A clinically effective and a cost-effective treatment option for dyslipidaemia

Although statins are first-line treatment for most patients with dyslipidaemia, some people require additional or alternative treatment to modify their lipid profile. Many patients treated with statins still fail to achieve increasingly stringent LDL-C goals in clinical practice, and can benefit from add-on ezetimibe therapy, which has a complementary mechanism of action to other drugs in current use. Many clinical studies have demonstrated that combinations of ezetimibe with statins, fibrates, and other lipid-modifying therapies, provide better normalisation of lipid profiles than these drugs given as monotherapy. Moreover, ezetimibe is also effective as a monotherapy. The safety and tolerability profile of ezetimibe as monotherapy is similar to placebo, and is also excellent when given in combination with other lipid-modifying agents. Ezetimibe may also provide a cost-effective alternative to statin titration. These findings suggest that ezetimibe represents a useful alternative and adjunct to other lipid management strategies. © 2008 CSF Medical Communications Ltd

Health Heritage\u3csup\u3e©\u3c/sup\u3e, a Web-Based Tool for the Collection and Assessment of Family Health History: Initial User Experience and Analytic Validity

A detailed family health history is currently the most potentially useful tool for diagnosis and risk assessment in clinical genetics. We developed and evaluated the usability and analytic validity of a patient-driven web-based family health history collection and analysis tool. Health Heritage © guides users through the collection of their family health history by relative, generates a pedigree, completes risk assessment, stratification, and recommendations for 89 conditions. We compared the performance of Health Heritage to that of Usual Care using a nonrandomized cohort trial of 109 volunteers. We contrasted the completeness and sensitivity of family health history collection and risk assessments derived from Health Heritage and Usual Care to those obtained by genetic counselors and genetic assessment teams. Nearly half (42%) of the Health Heritage participants reported discovery of health risks; 63% found the information easy to understand and 56% indicated it would change their health behavior. Health Heritage consistently outperformed Usual Care in the completeness and accuracy of family health history collection, identifying 60% of the elevated risk conditions specified by the genetic team versus 24% identified by Usual Care. Health Heritage also had greater sensitivity than Usual Care when comparing the identification of risks. These results suggest a strong role for automated family health history collection and risk assessment and underscore the potential of these data to serve as the foundation for comprehensive, cost-effective personalized genomic medicine