Virtual Kitchen Test. Assessing frontal lobe functions in patients with alcohol dependence syndrome.

INTRODUCTION: This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". BACKGROUND: The ecological validity of paper-and-pencil neuropsychological tests is currently a matter of debate. Arguments in favor of alternatives indicate that paper-and-pencil forms are unable to account for both mental and functional aspects of cognitive functioning. OBJECTIVES: In this study we developed a new neuropsychological evaluation test - the Virtual Kitchen Test (VKT) - devised to evaluate frontal brain functioning in cognitively impaired individuals. We designed this test according to the rationale of the Trail Making Test (TMT), in order to capture frontal lobe abilities during a more ecologically valid task. METHODS: Forty-nine participants, 25 from a clinical sample of patients diagnosed with Alcohol Dependence Syndrome, plus 24 healthy participants. RESULTS: Execution errors and task completion time were significantly higher in the clinical sample. Also, scores on the new VKT showed moderate to high positive correlations with scores on the TMT. Furthermore, the overall discriminant performance of the VKT was high for both of its indicators. CONCLUSIONS: Overall results support the ability of the VKT to evaluate frontal lobe functions. The best cut-off scores based on this sample are discussed.

[Systemic vasculitis as the initial presentation of a left atrial myxoma]. / Vasculite sistémica como apresentação inicial de um mixoma auricular esquerdo.

Left atrial myxoma remains a diagnostic challenge. The authors briefly review previously reported cases and their individualistic clinical and laboratory features. This report documents an unusual clinical presentation, initially directing attention to the central nervous system as well as bilateral tenderness and weakness of the extremities. The illness was considered to be a vasculitis until thirty-one months later when the diagnosis of left atrial myxoma was made. The tumor was successfully removed.