Longevity of immediate rehabilitation with direct metal-wire reinforced composite fixed partial dentures.

OBJECTIVES: This study aimed to analyze the longevity of direct metal-wire reinforced composite fixed partial dentures (MRC-FPD) and factors influencing their survival and success. METHODS: Within one private practice 513 MRC-FPD were directly applied. The preparation of a proximal cavity in abutment teeth was not limited. MRC-FPD were reinforced by one to three metal-wires. At the last follow-up MRC-FPD were considered successful, if they were still in function without any need of therapy. MRC-FPD were considered as survived, if they were repaired or replaced. Multi-level Cox proportional hazard models were used to evaluate the association between clinical factors and time. RESULTS: Mean follow-up period (range) was 59(2-249) months. Seventy-three bridges did not survive (cumulative survival rate(CSR):86%) and further 129 bridges had received a restorative follow-up treatment (CSR:61%). AFR was 2.2% for survival and 8.6% for success. In multivariate analysis MRC-FPD with> 1 wire showed a up to 2.3x higher failure rate than MRC-FPD with one wire(p ≤ 0.023). Dentist's experience in designing MRC-FDP (p ≤ 0.017), patient's caries risk (p ≤ 0.040) and bruxism (p = 0.033) significantly influenced the failure rate: the more experience, the lower caries risk and bruxism, the lower the failure rate. SIGNIFICANCE: For directly prepared metal-wire reinforced composite bridges high survival and moderate success rates were observed. MRC-FPD might, thus, be an immediate, short- and medium-term solution for replacing missing teeth. However, several factors on the levels of practice (dentist's experience in designing MRC-FDP), patient (bruxism, caries risk) and restoration (number of wires) were identified as significant predictors for the failure rate. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00021576).

Cytokine release syndrome-associated encephalopathy in patients with COVID-19.

BACKGROUND AND PURPOSE: Neurological manifestations in coronavirus disease (COVID)-2019 may adversely affect clinical outcomes. Severe COVID-19 and uremia are risk factors for neurological complications. However, the lack of insight into their pathogenesis, particularly with respect to the role of the cytokine release syndrome (CRS), is currently hampering effective therapeutic interventions. The aims of this study were to describe the neurological manifestations of patients with COVID-19 and to gain pathophysiological insights with respect to CRS. METHODS: In this longitudinal study, we performed extensive clinical, laboratory and imaging phenotyping in five patients admitted to our renal unit. RESULTS: Neurological presentation included confusion, tremor, cerebellar ataxia, behavioral alterations, aphasia, pyramidal syndrome, coma, cranial nerve palsy, dysautonomia, and central hypothyroidism. Notably, neurological disturbances were accompanied by laboratory evidence of CRS. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was undetectable in the cerebrospinal fluid (CSF). Hyperalbuminorrachia and increased levels of the astroglial protein S100B were suggestive of blood-brain barrier (BBB) dysfunction. Brain magnetic resonance imaging findings comprised evidence of acute leukoencephalitis (n = 3, one of whom had a hemorrhagic form), cytotoxic edema mimicking ischaemic stroke (n = 1), or normal results (n = 2). Treatment with corticosteroids and/or intravenous immunoglobulins was attempted, resulting in rapid recovery from neurological disturbances in two cases. SARS-CoV2 was undetectable in 88 of the 90 patients with COVID-19 who underwent Reverse Transcription-PCR testing of CSF. CONCLUSIONS: Patients with COVID-19 can develop neurological manifestations that share clinical, laboratory and imaging similarities with those of chimeric antigen receptor T-cell-related encephalopathy. The pathophysiological underpinnings appear to involve CRS, endothelial activation, BBB dysfunction, and immune-mediated mechanisms.

Longevity of immediate rehabilitation with direct fiber reinforced composite fixed partial dentures after up to 9 years.

OBJECTIVES: This retrospective, single-center, practice-based cohort study aimed to analyze the longevity of direct fiber reinforced composite fixed partial dentures (DFRC-FPD) and to analyze factors influencing their survival and success. METHODS: Within one private practice 100 DFRC-FPD were directly applied. The preparation of a proximal cavity was limited to abutment teeth with an existing filling (minimal-invasive approach). All intact enamel surfaces were preserved (micro-invasive approach). DFRC-FPD were reinforced by fiber-splints with semi polymer network matrices (Everstick C + B©). At the last follow-up DFRC-FPD were considered successful if they were still in function without any need of therapy. DFRC-FPD were considered as survived if they were repaired or replaced. Multi-level Cox proportional hazard models were used to evaluate the association between clinical factors and time. RESULTS: Within a mean follow-up period (range) of 53 (2-109) months 7 bridges did not survive (cumulative survival rate: 93%) and further 24 bridges had received a restorative follow-up treatment (cumulative success rate: 69%). The annual failure rate was 1.6% for survival and 8.3% for success. The main failure type was fracture of the composite material (n = 30). In multivariate analysis no significant predictor could be found for success and survival. CONCLUSIONS: For directly prepared fiber reinforced composite bridges high survival and moderate success times were observed after up to nine years. Based on the present results DFRC-FPD might be an immediate, short- to medium-term solution for replacing 1 to 2 missing teeth with no or minimal tooth preparation. CLINICAL SIGNIFICANCE: Within the limitations of the present study DFRC-FPD offered an immediate, micro-/minimal-invasive, inexpensive short- and medium-term solution to replace missing teeth, even if no box-shaped proximal cavity was prepared.

The skull vibration-induced nystagmus test: A useful vestibular screening test in children with hearing loss.

INTRODUCTION: Skull-Vibration-Induced-Nystagmus Test (SVINT), a non-invasive first line examination test, stimulates both otolith and canal structures and shows instantaneously a vestibular asymmetry. This study aimed to analyze the SVINT results observed in children with hearing loss (HL) amplified with hearing aids (HA) or unilateral cochlear implant (uCI) and healthy children. MATERIAL AND METHODS: This case-control study compared the results of SVINT, caloric test (CaT) and video head-impulse-test (VHIT) in 120 controls to 30 children with HA and 30 with uCI, aged 5-18 years old. SVINT was recorded with videonystagmography after very high frequency (VHF) stimulation of mastoids and vertex. RESULTS: SVINT results were non-pathological in 98% of the control group but modified in the HL group (P-value=0.04). In uCI participants, 13.3% had a bilateral weakness (BW) and 16.7% had a unilateral weakness (UW). In the HA group, 26.7% had BW, 10% had UW. SVINT was efficient to show a UW (6 out of 7 confirmed cases) but not efficient to show BW (1/12 confirmed cases). CONCLUSION: SVINT can detect unilateral vestibular deficit in the VHF with a sensitivity of 86% and specificity of 96%. The positive predictive value is 75% and negative predictive value is 98%. In the case of bilateral deficit, the SVINT is inoperant. In amplified participants, a UW was equally detected whether using SVINT, CaT or VHIT. SVINT is a well-tolerated and useful test to screen vestibular asymmetry in children with HL when combined with other vestibular tests and shows its complementary at very high frequencies.

Probing the adsorption/desorption of amphiphilic polymers at the air-water interface during large interfacial deformations.

Hydrophobically modified polymers are good candidates for the stabilization of liquid interfaces thanks to the high anchoring energy of the hydrophobic parts. In this article we probe the interfacial anchoring of a series of home-made hydrophobically modified polymers with controlled degree of grafting by studying their behavior upon large area dilations and compressions. By comparing the measured interfacial tension to the one that we expect in the case of a constant number of adsorbed monomers, we are able to deduce whether desorption or adsorption occurs during area variations. We find that the polymer chains with the longest hydrophobic grafts desorb at larger compressions compared to the polymers with the shortest grafts, because of their larger desorption energy. Furthermore, for a given graft length, we observe more desorption for polymers with the highest grafting densities. We attribute this counter intuitive result to the fact that at high grafting densities, the length of the polymer loops is shorter, and hence the elastic penalty upon compression is larger for these layers, leading to a faster desorption. Comparing the elastic penalty to thermal energy, kBT, enables deducing a critical grafting density above which desorption of grafts is expected upon compression, which is consistent with our experimental results. In the case of large area dilations, the experiments reveal that the number of adsorbed anchors remains constant in the case of chains with a low grafting density while chains with the highest degree of grafting seem to show some degree of adsorption during the dilatation. Therefore, in these highly grafted chains there may be unadsorbed grafts remaining in the vicinity of the interface, which may adsorb quickly at the interface upon dilatation.

Skull vibration induced nystagmus in patients with superior semicircular canal dehiscence.

OBJECTIVE: To establish optimum stimulus frequency and location of bone conducted vibration provoking a skull vibration induced nystagmus (SVIN) in superior semi-circular canal dehiscences. METHODS: SVIN 3D components in 40 patients with semi-circular canal dehiscence (27 unilateral and 13 bilateral) were compared with a group of 18 patients with severe unilateral vestibular loss and a control group of 11 volunteers. RESULTS: In unilateral semi-circular canal dehiscences, SVIN torsional and horizontal components observed on vertex location in 88% beat toward the lesion side in 95%, and can be obtained up to 800Hz (around 500Hz being optimal). SVIN slow-phase-velocity was significantly higher on vertex stimulation at 100 and 300Hz (P=0.04) than on mastoids. SVIN vertical component is more often upbeating than downbeating. A SVIN was significantly more often observed in unilateral than bilateral semi-circular-canal dehiscences (P=0.009) and with a higher slow phase velocity (P=0.008). In severe unilateral vestibular lesions the optimal frequency was 100Hz and SVIN beat toward the intact side. The mastoid stimulation was significantly more efficient than vertex stimulation at 60 and 100Hz (P<0.01). CONCLUSION: SVIN reveals instantaneously in unilateral semi-circular canal dehiscences a characteristic nystagmus beating, for the torsional and horizontal components, toward the lesion side and with a greater sensitivity toward high frequencies on vertex stimulation. SVIN three components analysis suggests a stimulation of both superior semi-circular canal and utricle. SVIN acts as a vestibular Weber test, assessing a vestibular asymmetrical function and is a useful indicator for unilateral semi-circular canal dehiscence.

Executive and nonexecutive demands of constructional measures within a children's psychiatric inpatient setting.

This study examined the role of executive functioning in constructional task performance (measured with the Rey Complex Figure Test-Copy Condition [RCFT] and Beery-Buktenica Developmental Test of Visual-Motor Integration [Beery-VMI]) within a children's psychiatric inpatient setting. A chart review was conducted for 88 children (aged 6-12) who received a neuropsychological evaluation during a psychiatric inpatient hospitalization. Multiple regression analyses investigated the role of executive and nonexecutive demands on RCFT and Beery-VMI performance. Forty-three percent of the sample displayed a constructional weakness. Children with a constructional weakness had lower FSIQ scores and a higher rate of executive dysfunction. Performance on the RCFT was independently predicted by perceptual ability (i.e., Matrix Reasoning; p = .008; ß = .340) and attention/executive dysfunction (p = .003; ß = -.342; 9.4% of variance), while performance on the Beery-VMI was independently predicted by constructional ability (i.e., Block Design; p = .004, ß = .338). Results of this study demonstrate that the RCFT has greater executive demand than the VMI and yields a greater rate of impaired performance in an inpatient child sample as compared to the VMI. Clinical and research practices should consider the distinct differences between various constructional measures to ensure their proper use and interpretation with consideration to their varying executive and nonexecutive demands.

Adsorption dynamics of hydrophobically modified polymers at an air-water interface.

Using surface-tension measurements, we study the brush-limited adsorption dynamics of a range of amphiphilic polymers, PAAH-[Formula: see text]-[Formula: see text] composed of a poly(acrylic acid) backbone, PAAH, grafted with a fraction [Formula: see text] of alkyl moieties, containing either n = 8 or n = 12 carbon atoms, at pH conditions where the PAAH backbone is not charged. At short times, the surface tension decreases more sharply as the degree of grafting increases, while, at long times, the adsorption dynamics becomes logarithmic in time and is slower as the degree of grafting increases. This logarithmic behavior at long times indicates the building of a free-energy barrier which grows over time. To account for the observed surface tension evolution with the degree of grafting we propose a scenario, where the free-energy barrier results from both the deformation of the incoming polymer coils and the deformation of the adsorbed brush. Our model involves only two fitting parameters, the monomer size and the area needed for one molecule during adsorption and is in agreement with the experimental data. We obtain a reasonable value for the monomer size and find an area per adsorbed polymer chain of the order of 1 nm2, showing that the polymer chains are strongly stretched as they adsorb.

Neutron reflectivity measurements at the oil/water interface for the study of stimuli-responsive emulsions⋆.

Stable stimuli-responsive emulsions between oil and water are formed with an amphiphilic block copolymer bearing polystyrene (PS) and poly(dimethylaminoethyl methacrylate) (PDMAEMA) moieties. Different kinds of emulsions like direct, multiple or inverse ones are reproducibly formed as a function of chemical parameters such as p H and salt concentration. To test the correlation between the different nature of the emulsion and the conformation of the polymer chain at the interface, neutron reflectometry at the oil/water interface was carried out. An original sample cell was built and the procedure to get reliable results with it on the FIGARO reflectometer at the Institut Laue-Langevin is described. Results show that for direct emulsions, the copolymer is much more extended on the water side than on the oil side. In the case where multiple emulsions are stabilized, the conformation is strongly modified and is compatible with a more equilibrated extension of the chain on both sides. The inverse case shows that the extension in oil is stronger than in water. These results are discussed in term of polymer brushes (charged or neutral) extension with respect to salt addition and hydrophobic interactions.

Near visual acuity of dental hygienists with and without magnification.

OBJECTIVES: The aim of this study was (i) to evaluate the visual performance of dental hygienists in their clinical environment and (ii) to analyse the relationship between self-assessed and objectively measured visual acuity. METHODS: The near visual acuity of 191 dental hygienists and dental hygiene students was self-assessed with a visual analogue scale and objectively measured with miniaturized visual tests in a simulated clinical setting. The visual acuity was also measured with magnification aids if they were part of the individual clinical equipment. The influence of age and magnification on the near visual acuity was analysed. RESULTS: The visual performance with respect to dental working distance showed a variability of 300% in the dimension of the smallest recognized structure. A weak positive correlation between the self-assessed and objectively measured visual performance (Spearman's rank correlation = 0.27) and a highly significant impact of the test person's age and the use of loupes (both P < .0001) were found. Test subjects ≥40 years exhibited a similar visual acuity when using loupes compared to the visual acuity of test subjects <40 years without loupes. CONCLUSIONS: The visual performance with respect to dental working distance cannot be self-assessed and varies individually. Dental hygienists and students of dental hygiene with a weak near visual acuity were not aware of their deficiencies. Optical aids should be used to compensate for individual visual deficiencies and are mandatory above an age of 40 years due to the effects of presbyopia.

Effect of Magnification on the Precision of Tooth Preparation in Dentistry.

OBJECTIVES: To evaluate the impact of magnification aids on the precision of tooth preparation under simulated clinical conditions. METHODS AND MATERIALS: Two plastic blocks marked with a geometric shape were fixed in a dental phantom head: a circle as the distal surface of tooth 16 (UNS 3) and a y-shaped figure as the occlusal surface of tooth 36 (UNS 19). Sixteen dentists (mean age: 39 years; range: 26-67 years) prepared the geometric shapes from the inside to the boundary line with a cylindrical bur and water-cooling. The boundary line had to be touched but not erased. Chair-side assistance was provided to simulate the clinical situation. Tooth 16 was prepared under indirect vision via a dental mirror. Tooth 36 was prepared under direct vision A) without magnification aids, B) with Galilean loupes, 2.5× and light-emitting diode light, and C) with a microscope, 6.4× and coaxial light. The preparation procedure was performed three times in different sequences of the magnification devices and with a break of at least 1 week between each procedure. The correctly prepared contour and the incorrectly prepared areas were evaluated in relation to the whole circumference of the geometric shapes. RESULTS: For both values the precision was significantly higher when a microscope was used, followed by preparation using loupes; precision was lowest without magnification aids ( p<0.0001). This was true for both indirect and direct vision ( p<0.05). CONCLUSIONS: Magnification devices improved the precision of tooth preparation under simulated clinical conditions.

Decision-making in fecal occult blood test compliance: A quali-quantitative study investigating motivational processes.

The qualitative-quantitative study investigates the co-existence of barriers and levers to FOBT screening in 5894 individuals reluctant to be screened, identifying operational motivational patterns that may increase screening compliance. Co-occurrence analysis was performed according to three motivational conditions (barriers, levers, or both).Cluster analysis then identified motivational predictors of effective screening. One quarter of the individuals who had refused screening nevertheless expressed at least one motivation towards FOBT. As such, co-existence of barriers and levers within the same individual demonstrates ambivalence tendencies. Intrinsic motivations appear to be the most likely to increase FOBT compliance. This study finds that certain factors well-known to improve CRC screening compliance generally, may not have much impact on reluctant individuals due to ambivalence and contextual nuances. Several practical recommendations to encourage screening participation are offered, such as focusing on levers rather barriers, providing tailored education to improve awareness and readiness, and fostering intrinsic motivation with relevant approaches.

A Near Visual Acuity Test for Dentists.

Unimpaired near vision is crucial in dentistry, but appropriate visual tests at dental working distance are not publicly available. The aim of this study was to validate a novel visual triage test for dentists that is easy to use and freely available. The near visual acuity at 300 mm of 106 dental professionals (aged 21-65 years) was assessed with 1) a validated near visual test for scientific purposes miniaturized on a microfilm; 2) an experimental test using a US $5 bill, in which the first five words of each line in the Lincoln Memorial frieze had to be read under a dental operating light. The Spearman rank correlation coefficient of 0.784 revealed a strong correlation between the two tests (p<0.0001). The ability to read six or more words in the memorial frieze meant there was a 94% chance of having a validated near visual acuity greater than or equal to the median score of the dentists tested. If none of the words could be read, the chance of having a near visual acuity below the median of the peer group was 89%. The influence of the dentists' age and experience on their visual performance reported in former studies was corroborated with this new test. The US $5 bill offers a simple and easily available near visual test to rank individuals' near vision relative to that of other dentists and to recognize the progression of presbyopia with increasing age.

Tailored telephone counselling to increase participation of underusers in a population-based colorectal cancer-screening programme with faecal occult blood test: A randomized controlled trial.

BACKGROUND: Despite the involvement of general practitioners, the mailing of several recall letters and of the faecal occult blood test (FOBT) kit, the uptake remains insufficient in the French colorectal cancer-screening programme. Some studies have demonstrated a greater efficacy of tailored telephone counselling over usual care, untailored invitation mailing and FOBT kit mailing. We evaluated the feasibility and the effectiveness of telephone counselling on participation in the population-based FOBT colorectal cancer-screening programme implemented in Alsace (France). METHODS: Underusers were randomized into a control group with untailored invitation and FOBT kit mailing (n=19,756) and two intervention groups for either a computer-assisted telephone interview (n=9367), system for tailored promotion of colorectal cancer screening, or a telephone-based motivational interview (n=9374). RESULTS: Only 5691 (19.9%) people were actually counseled, so that there was no difference in participation between the intervention groups taken together (13.9%, 95% confidence interval [CI] [13.5-14.4]) and the control group (13.9%, 95% CI [13.4-14.4]) (P=1.0) in intent-to-treat analysis. However, in per-protocol analysis, participation was significantly higher in the two intervention groups than in the control group (12.9%, 95% CI [12.6-13.2]) (P<0.01), with no difference between computer-assisted telephone interview (24.6%, 95% CI [22.7-26.4]) and motivational interview (23.6%, 95% CI [21.8-25.4]) (P=0.44). CONCLUSION: There was no difference of effectiveness between tailored telephone counselling and untailored invitation and FOBT kit mailing on participation of underusers in an organized population-based colorectal cancer screening programme. A greater efficacy of telephone counselling, around twice that of invitation and FOBT kit mailing, was observed only in people who could actually be counseled, without difference between computer-assisted telephone interview and motivational interview. However, technical failures hampered telephone counselling, so that there was no difference in intent-to-treat analysis. The rate of technical success of telephone interviews should be evaluated, and enhanced if insufficient, before implementation of telephone counselling in population-based cancer screening programmes.

Failure to maintain set as a predictor of childhood depression within a children's psychiatric inpatient sample.

Despite a wealth of studies in adults and adolescents, only a handful of studies have examined executive function in childhood depression. This study utilized retrospective chart review of a children's psychiatric inpatient program to evaluate executive function via Wisconsin Card Sorting Test (WCST) in 33 children (6-12 years old) with a depressive disorder and 61 age/sex-matched children without a depressive disorder referred for neuropsychological evaluation. WCST categories, perseverative errors, and failure to maintain set errors were examined as potential predictors of depressive disorder diagnosis and self-reported depressive symptoms. After controlling for age, length of hospital stay, and ADHD, failure to maintain set significantly predicted depressive disorder diagnosis. Failure to maintain set was also significantly associated with self-reported depressive symptoms. Current findings provide preliminary evidence to suggest that failure to maintain set may reflect a core deficit of childhood depression. While findings are preliminary, this may have important implications for the diagnosis and treatment of childhood depression.

[Hospitalization rate in relation to severe complications of transrectal prostate biopsy: About 2715 patients biopsied]. / Taux d'hospitalisations en rapport avec des complications sévères des biopsies de prostate transrectales : à propos de 2715 patients biopsiés.

MAIN OBJECTIVE: To identify hospitalizations directly related to a complication occurring within 30 days following a transrectal prostate biopsy (PBP). SECONDARY OBJECTIVES: Overall hospitalization rates, mortality rates, potential predisposing factors for complications. PATIENTS AND METHODS: Single-center study including all patients who underwent PBP between January 2005 and January 2012. Any hospitalization occurring within 30 days of the PBP for urgent motive was considered potentially attributable to biopsy. We identified the reason for hospitalization with direct complications (urinary infection or fever, rectal bleeding, bladder caillotage, retention) and indirect (underlying comorbidities decompensation) of the biopsy. The contributing factors were anticoagulant or antiplatelet treatment well as waning immunity factors (corticosteroid therapy, HIV, chemotherapy or immunodulateur). RESULTS: Among 2715 men who underwent PBP, there were 120 (4.4%) hospitalizations including 28 (1.03%) caused by the biopsy. Twenty-five (0.92%) were related to a direct complication of biopsy: 14 (56%) for urinary tract infection or fever including 1 hospitalization in intensive care, 5 (20%) for rectal bleeding which required several transfusions 1, 10 (40%) urinary retention and 3 (0.11%) for an indirect complication (2 coronary syndromes and 1 respiratory failure). Several direct complications were associated in 3 cases. Only two hospitalizations associated with rectal bleeding were taking an antiplatelet or anticoagulant. There was no association between hospitalization for urinary tract infections and a decreased immune status. The first death observed in our study occurred at D31 of pulmonary embolism (advanced metastatic patient with bladder cancer). Twenty (60.6%) patients urgently hospitalized did not have prostate cancer. CONCLUSIONS: Within this large sample of patients the overall rate of hospitalization due to the realization of a PBP was 1%. It has not been found predictive of complications leading to hospitalization. LEVEL OF EVIDENCE: 4.

Neurocognitive Phenotypes in Severe Childhood Psychiatric Disorders.

This study investigated the presence of potential neurocognitive phenotypes within a severe childhood psychiatric sample. A medical chart review was conducted for 106 children who received a neuropsychological evaluation during children's psychiatric inpatient program hospitalization. A hierarchical cluster analysis was conducted to identify distinct clinical clusters based on neurocognitive measures. Cluster analysis identified four distinct clusters, subsequently labeled neurocognitive phenotypes: "intact cognition" (27%), "global dysfunction" (20%), "organization/planning" (21%), and "inhibition-memory" (32%). Significant differences were identified in history of legal involvement and antipsychotic medications at hospital admission. Differences between none-minimal and moderate-high neurocognitive dysfunction were identified in age, amount of diagnoses and antipsychotic medications at admission, and hospital length of stay. Current findings provide preliminary evidence of underlying neurocognitive phenotypes within severe childhood psychiatric disorders. Findings highlight the importance of neuropsychological evaluation in the treatment of childhood psychiatric disorders.

Verbal Memory Abilities in Severe Childhood Psychiatric Disorders and the Influence of Attention and Executive Functions.

Despite prior adult research regarding the influence of executive functions on memory performance, there has been inconsistent prior research on the role of executive functions on memory performance in children, particularly those children with severe psychiatric disorders. A medical chart review was conducted for 76 children (ages 6-12 years) who received a neuropsychological evaluation during children's psychiatric inpatient program hospitalization. A series of hierarchical regression analyses investigated the role of attention/executive and non-executive functions in verbal memory performance (immediate recall, delayed recall, and delayed recognition). Demographic and verbal measures were entered into blocks 1 and 2 for all analyses, followed by attention and executive functions (i.e., attention span, sustained attention, verbal fluency, cognitive flexibility, inhibitory control, and planning/organization). Nearly 15% of the participants displayed memory impairment. Results of regression analyses indicated attention/executive dysfunction severity predicted overall memory performance. Attention span predicted performance on all three memory conditions. Planning/organization accounted for unique variance in immediate recall condition while inhibitory control accounted for unique variance in delayed recall condition. These results indicate that verbal memory problems frequently occur in severe childhood psychiatric disorders. Further, planning/organization deficits may influence immediate recall, while inhibitory control deficits may influence delayed recall. Alternatively, delayed recognition memory may be the most resistant to the negative influence of executive deficits on verbal memory performance in childhood psychiatric disorders.

How to perform the skull vibration-induced nystagmus test (SVINT).

The skull vibration-induced nystagmus test is a robust, nonintrusive and easy to perform test. This test acts as a vestibular Weber test and is performed as a bedside examination. It usually instantaneously reveals vibration-induced nystagmus (VIN) even in long standing or chronic compensated unilateral vestibular lesions. The test requires stimulation at 30, 60 or more efficiently at 100Hz. The vibrator is applied perpendicularly to the skin on a subject sitting up straight on the right and then the left mastoid (level with external acoustic meatus) and vertex. The VIN can be observed under videonystagmoscopy or Frenzel goggles. Either the direct tracing or the VIN slow phase velocity can be recorded on a 2D or 3D videonystagmograph. The patients should be relaxed and not treated by strong sedative medications. This rapid first-line test is not influenced by vestibular compensation and usefully complements other tests in the multifrequency evaluation of the vestibule. It acts as a global vestibular test by stimulating both canal and otolithic structures at 100Hz. It is useful in case of external acoustic meatus or middle ear disease as a substitute for the water caloric test and is preferable in elderly patients with vascular disease or arthritis of the neck to the head-shaking-test or head-impulse-test.