[Considerations on the treatment of IgA nephropathy on the basis of the results of the latest studies (STOP-IgAN, TESTING, NEFIGAN)]. / Terápiás megfontolások IgA-nephropathiában a legutolsó vizsgálatok (STOP-IgAN, TESTING, NEFIGAN) eredményei alapján.

IgA nephropathy is an immune-mediated chronic glomerulonephritis with a great variability in clinical presentation and outcome. The disease can progress to end-stage renal failure in 25% of patients. For this reason we should identify patients with potential to progress. Most important risk factors for progression are persistent proteinuria, hypertension, decreased renal function and some histological lesions. The actually suggested treatment is summarized in KDIGO Clinical Practice Guideline from 2012. They suggest to give firstly non-specific supportive treatment (especially renin-angiotensin system blocking agents). Recommendation about steroid/immunosuppression treatment is based on low level of evidence. Recently three studies were organised concerning benefits and risk of steroid/immunosuppressive treatment added together with specific supportive treatment. In the STOP-IgAN study, systemic steroid/immunosuppressive treatment significantly decreased proteinuria but did not stop progression. In the TESTING study, systemic steroid treatment significantly decreased proteinuria and progression. However, the study was recently discontinued due to several severe side effects of steroid treatment. Involvement of intestinal mucosal immunity in the pathogenesis of IgA nephropathy suggested the NEFIGAN study with budesonide treatment. Budesonide releases corticosteroid in distal small intestine and colon. Proteinuria was significantly decreased and renal function remained stabile. High number of withdrawals owing to adverse effects is a major concern implying a substantial systemic effect of budesonide. We need further information on the characteristics of patients who most likely benefit from steroid/immunosuppressive treatment given after or together with specific supportive treatment. Orv Hetil. 2017; 158(49): 1946-1952.

Feature binding and attention in working memory: a resolution of previous contradictory findings.

We aimed to resolve an apparent contradiction between previous experiments from different laboratories, using dual-task methodology to compare effects of a concurrent executive load on immediate recognition memory for colours or shapes of items or their colour-shape combinations. Results of two experiments confirmed previous evidence that an irrelevant attentional load interferes equally with memory for features and memory for feature bindings. Detailed analyses suggested that previous contradictory evidence arose from limitations in the way recognition memory was measured. The present findings are inconsistent with an earlier suggestion that feature binding takes place within a multimodal episodic buffer Baddeley, ( 2000 ) and support a subsequent account in which binding takes place automatically prior to information entering the episodic buffer Baddeley, Allen, & Hitch, ( 2011 ). Methodologically, the results suggest that different measures of recognition memory performance (A', d', corrected recognition) give a converging picture of main effects, but are less consistent in detecting interactions. We suggest that this limitation on the reliability of measuring recognition should be taken into account in future research so as to avoid problems of replication that turn out to be more apparent than real.

What you say matters: exploring visual-verbal interactions in visual working memory.

The aim of this study was to explore whether the content of a simple concurrent verbal load task determines the extent of its interference on memory for coloured shapes. The task consisted of remembering four visual items while repeating aloud a pair of words that varied in terms of imageability and relatedness to the task set. At test, a cue appeared that was either the colour or the shape of one of the previously seen objects, with participants required to select the object's other feature from a visual array. During encoding and retention, there were four verbal load conditions: (a) a related, shape-colour pair (from outside the experimental set, i.e., "pink square"); (b) a pair of unrelated but visually imageable, concrete, words (i.e., "big elephant"); (c) a pair of unrelated and abstract words (i.e., "critical event"); and (d) no verbal load. Results showed differential effects of these verbal load conditions. In particular, imageable words (concrete and related conditions) interfered to a greater degree than abstract words. Possible implications for how visual working memory interacts with verbal memory and long-term memory are discussed.

What goes through the gate? Exploring interference with visual feature binding.

A series of experiments explored the mechanisms determining the encoding and storage of features and objects in visual working memory. We contrasted the effects of three types of visual suffix on cued recall of a display of colored shapes. The suffix was presented after the display and before the recall cue. The latter was either the color or shape of one of the objects and signaled recall of the object's other feature. In Experiments 1 and 2, we found a larger effect of 'plausible' suffixes comprising features (color and shape) drawn from the experimental set, relative to the effect of 'implausible' suffixes comprising features outside the experimental set. Experiment 3 extended this pattern by showing that 'semi-plausible' suffixes containing only one feature (either color or shape) from the experimental set had an equivalent effect to those with both features from the set. Reduction in accuracy was mainly due to an increase in recall of suffix features, rather than within-display confusions. The findings suggest a feature-based filtering process in visual working memory, with any stimuli that pass through this filter serving to directly overwrite existing object representations.

Visual similarity at encoding and retrieval in an item recognition task.

The aim of this experiment was to examine the effects of shape similarity in visual working memory using a six alternative recognition task of Chinese characters. Shape similarity among items was manipulated at both encoding and retrieval in order to assess in which phase similarity impairs recognition to a greater degree. Results revealed that performance is particularly facilitated by high discriminability at retrieval but also by the presence of similar items at encoding, as similarity simplifies the global representation of the display and reduces memory load. Moreover, results provide further evidence that the classical similarity effect can be reversed in the visual domain when item memory (as opposed to order) is assessed.