Cognitive difficulty in physicians.

Purpose: Remediation of some incompetent physicians has proven difficult or impossible. The authors sought to determine whether physicians with impaired competency had neuropsychological impairment sufficient to explain their incompetence and their failure to improve with remedial continuing medical education (CME).

Method: During a one-year period, 1996-97, all 27 participants in the Physician Review Program (PREP) conducted at McMaster University, a physician competency assessment program, undertook a detailed neuropsychological screening battery.

Cognition and mood in systemic lupus erythematosus. Evaluation and pathogenesis.

Cognitive dysfunction is frequent in SLE, probably related to primary underlying immune/inflammatory mechanisms operating in the brain. Longitudinal studies relating patterns of cognitive impairment to putative pathogenetic factors would provide evidence for this hypothesis. Such studies could also lead to more specific therapeutic interventions to ameliorate or reverse brain compromise in SLE.

The relationship of antiphospholipid antibodies to cognitive function in patients with systemic lupus erythematosus.

Objective: To examine the relationship between antiphospholipid antibody positivity (expressed as the lupus anticoagulant) and cognitive dysfunction in patients with systemic lupus erythematosus (SLE).

Methods: Cross-sectional comparisons of lupus anticoagulant (LA) positive (N = 39) and negative (N = 79) patients and controls (N = 35) on a cognitive test battery; 22 LA-positive and 53 LA-negative patients who had never experienced neuropsychiatric events (never-NP-SLE) were also compared separately.

Results: LA-positive patients were 2 to 3 times more likely than were LA-negative patients to be designated as cognitively impaired.

Neurobehavioral outcomes among farm and nonfarm rural Ecuadorians.

International researchers have urged greater use of simple neurobehavioral batteries in developing country settings where higher levels of exposure and a variety of cultural and demographic factors may both occur. We conducted a cross-sectional survey of 144 farm members and 72 age and education frequency-matched controls from rural Ecuador, using an amplified Neurobehavioral Core Test Battery. Farm members ranged from those with only indirect pesticide contact to applicators regularly applying organophosphate and carbamate insecticides by backpack sprayer.

Psychological aspects of systemic lupus erythematosus: cognitive function, mood, and self-report.

Systemic lupus erythematosus (SLE) is a chronic relapsing/remitting autoimmune disorder with both primary and secondary effects on nervous system integrity and psychological functioning. In addition to the occurrence of clinical psychiatric syndromes such as psychosis, depression, and anxiety, other psychological problems documented with increased frequency in SLE include cognitive deficits and emotional distress. We examine issues related to cognitive function, including its assessment and prevalence, and confounding factors in interpreting cognitive problems as reflecting primary central nervous system involvement in SLE.