on behalf of the Hemangioma Investigator Group abstract BACKGROUND: There has been a dramatic increase in the off-label use of ophthalmic timolol maleate, a β-blocker used for infantile hemangioma (IH) treatment as a topical counterpart to oral propranolol. Its safety and efficacy in a pediatric population with IH have not been evaluated in a large cohort. Our goal was to retrospectively assess timolol's effectiveness, discern characteristics associated with response, and document reported adverse events.
Objective: The objective of this study was to determine which aspects of executive functions are most affected in behavioral variant frontotemporal dementia (bvFTD) and best differentiate this syndrome from Alzheimer disease (AD).
Methods:We compared executive functions in 22 patients diagnosed with bvFTD, 26 with AD, and 31 neurologically healthy controls using a conceptually driven and comprehensive battery of executive function tests, the NIH EXAMINER battery (http://examiner.ucsf.edu).Results: The bvFTD and the AD patients were similarly impaired compared with controls on tests of working memory, category fluency, and attention, but the patients with bvFTD showed significantly more severe impairments than the patients with AD on tests of letter fluency, antisaccade accuracy, social decision-making, and social behavior. Discriminant function analysis with jackknifed cross-validation classified the bvFTD and AD patient groups with 73% accuracy. Alzheimer disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are neurodegenerative diseases that affect executive functions.
Conclusions:1,2 Executive functions support goal-oriented behavior and include working memory, inhibition, mental flexibility, fluency, self-monitoring, and organizing appropriate social behavior. [3][4][5] It is unknown whether the executive impairments are the same in both disorders, or whether differences could assist with differential diagnosis.According to a recent meta-analysis of 94 studies, the frequently used executive function tests do not reliably differentiate FTD and AD. 6 Several of the studies included progressive aphasia patients with bvFTD, making the results difficult to interpret. Some studies have identified select measures of rule violation, poor planning, perseveration, letter fluency relative to category fluency, and organizing appropriate social behavior that are more impaired in bvFTD than AD. [7][8][9][10][11]
This novel study suggests that supplemental recorded video may improve the management accuracy of pediatric teledermatology consultations, particularly for complex cases. Residents may benefit from training in recording and interpreting video.
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