Prolonged hypocortisolemia in hydrocortisone replacement regimens in adrenocorticotrophic hormone deficiency.

Objectives: Studies of adults have shown that thrice-daily hydrocortisone dosing results in more physiologic cortisol profiles than twice-daily dosing. There are no data on thrice-daily dosing and only limited data on twice-daily dosing in children despite the possible adverse effects of glucocorticoid underreplacement or overreplacement.

Methods: Using 24-hour cortisol and glucose profiles, along with computerized cognitive testing, our aim was to assess prescribed hydrocortisone regimens in children and adolescents with hypopituitarism.

Effects of GH on cognitive function in elderly patients with adult-onset GH deficiency: a placebo-controlled 12-month study.

Objective: Young adults with childhood-onset GH deficiency (GHD) have reduced memory and attention, which can be improved by treatment with GH. Little information is available on cognitive function in elderly GHD patients.

Design: Single center, double-blind, randomized, placebo-controlled study of 52-week duration.

Practice effects associated with the repeated assessment of cognitive function using the CogState battery at 10-minute, one week and one month test-retest intervals.

There are many situations in which cognitive tests need to be administered on more than two occasions and at very brief test-retest intervals to detect change in group performance. However, previous literature has not specifically addressed these important issues. The main aim of the current study was to examine these two factors by using a computerized cognitive battery designed specifically for the repeated assessment of cognition (i.

The effects of growth hormone (GH) deficiency and GH replacement on cognitive performance in adults: a meta-analysis of the current literature.

Objective: There is growing evidence in the neuropsychological literature that growth hormone (GH) deficiency is associated with cognitive impairment. There is also evidence that this impairment may be ameliorated with GH replacement therapy. The current study assessed the nature and severity of cognitive impairment associated with growth hormone deficiency, as well as effect of GH replacement on cognitive function by conducting a meta-analysis of the published literature to date.

The nature and severity of cognitive impairment associated with adjuvant chemotherapy in women with breast cancer: a meta-analysis of the current literature.

Objective: Several studies have identified that adjuvant chemotherapy for breast cancer is associated with cognitive impairment; however, the magnitude of this impairment is unclear. This study assessed the severity and nature of cognitive impairment associated with adjuvant chemotherapy by conducting a meta-analysis of the published literature to date.

Method: Six studies (five cross-sectional and one prospective) meeting the inclusion criteria provided a total of 208 breast cancer patients who had undergone adjuvant chemotherapy, 122 control participants and 122 effect sizes (Cohen's d) falling into six cognitive domains.

Fatigue-related impairment in the speed, accuracy and variability of psychomotor performance: comparison with blood alcohol levels.

Cognitive performance is impaired by fatigue arising from sustained wakefulness and alcohol. Three recent papers directly compared the effects of increasing fatigue and blood alcohol concentration (%BAC) to provide a framework for understanding fatigue-related cognitive impairment. While the expression of fatigue-related cognitive impairments in terms of %BAC equivalents is sound, the methodology in each study was flawed in that the statistics used to compare the effects of %BAC and fatigue on cognition did not account for variation between or within each condition.

Qualitative similarities in cognitive impairment associated with 24 h of sustained wakefulness and a blood alcohol concentration of 0.05%.

Previous studies that have quantified fatigue-related cognitive impairment as blood alcohol concentration (BAC) equivalents have been limited by two issues: the effect of practice on tests of cognition and, more importantly, the statistic used to quantify change in cognitive performance. The current study addressed these issues by adopting an ABACA design, which allowed for the adequate control of practice effects, and by using effect size metrics, which enabled direct comparisons to be made in performance impairments as a result of fatigue (i.e.

Determining the extent of cognitive change after coronary surgery: a review of statistical procedures.

Currently, cognitive decline after coronary surgery is said to be significant if the individual's postoperative test score is at least 1 standard deviation (SD) worse than their preoperative score. This "1-SD" technique fails to account for factors that may confound interpretation of serially acquired cognitive test scores, including regression to the mean, measurement error caused by poor test-retest reliability, and practice effects. We review the many alternative and potentially superior statistical techniques that have been described in the neuropsychologic and psychiatric literature for differentiating "true" changes in cognitive test score from changes caused by these factors.