Increased blood pressure visit-to-visit variability in patients with systemic lupus erythematosus: association with inflammation and comorbidity burden.

BACKGROUND: Blood pressure visit-to-visit variability is a novel risk factor for deleterious long-term cardiac and renal outcomes in the general population. We hypothesized that patients with systemic lupus erythematosus (SLE) have greater blood pressure visit-to-visit variability than control subjects and that blood pressure visit-to-visit variability is associated with a higher comorbidity burden. METHODS: We studied 899 patients with SLE and 4172 matched controls using de-identified electronic health records from an academic medical center. We compared blood pressure visit-to-visit variability measures in patients with SLE and control subjects and examined the association between blood pressure visit-to-visit variability and patients' characteristics. RESULTS: Patients with SLE had higher systolic blood pressure visit-to-visit variability 9.7% (7.8-11.8%) than the control group 9.2% (7.4-11.2%), P < 0.001 by coefficient of variation. Additional measures of systolic blood pressure visit-to-visit variability (i.e. standard deviation, average real variation, successive variation and maximum measure-to-measure change) were also significantly higher in patients with SLE than in control subjects. In patients with SLE, blood pressure visit-to-visit variability correlated significantly with age, creatinine, CRP, triglyceride concentrations and the Charlson comorbidity score (all P < 0.05). Hydroxychloroquine use was associated with reduced blood pressure visit-to-visit variability (P < 0.001), whereas the use of antihypertensives, cyclophosphamide, mycophenolate mofetil and corticosteroids was associated with increased blood pressure visit-to-visit variability (P < 0.05). CONCLUSION: Patients with SLE had higher blood pressure visit-to-visit variability than controls, and this increased blood pressure visit-to-visit variability was associated with greater Charlson comorbidity scores, several clinical characteristics and immunosuppressant medications. In particular, hydroxychloroquine prescription was associated with lower blood pressure visit-to-visit variability.

A computer-assisted administration of the Continuous Visual Memory Test.

The Continuous Visual Memory Test (CVMT) is a continuous design recognition test designed for the assessment of visual memory for clinical and research applications. Comparisons were made between the traditional and a computer-assisted format of the CVMT using 51 university students. Formats were compared on five CVMT dependent measures, concurrent validity, split-half reliability, and selected dependent measures from the California Verbal Learning Test (CVLT). Participants scored higher on the computer format dependent measures, with the exception of false alarms (new items incorrectly identified as old), which remained comparable between formats. Adequate concurrent validity (r =.70) and split-half reliability (rs =.61-.70) were demonstrated for CVMT Total Score. Restriction of range and ceiling effects precluded reliability and validity conclusions for CVMT Delay. The computer format showed a nonsignificant trend towards lower correlations with CVLT dependent measures.

An automated administration of Corsi's Block-tapping Test.

Corsi's Block-tapping Test has been a clinically useful test of visuospatial memory. Participants (15 men, 15 women) completed an automated and a manual version of the Block-tapping Test, the findings for which suggest that the automated and manual versions gave very similar scores.

A revised spatial serial learning and memory procedure using Corsi's Block-tapping apparatus.

The purpose of this study was to use Corsi's Block Tapping Test as a spatial analog of Benton's Serial Digit Learning Test, using the cognitive neuroscience approach utilized in the California Verbal Learning Test. 60 normal participants, ages 19-52 years, were included and administered an 8-block sequence for 9 trials or until they recalled the entire sequence for 3 consecutive errorless trials. The score was the number of blocks tapped in the correct serial order. An interference trial was administered. Following a 10-min. delay, free recall of the original sequence, cued recall, and recognition measures were obtained. Retroactive interference was significant, but no proactive interference emerged. Scores showed a strong primacy effect. Most participants who learned the sequence to the criterion of three successive errorless trials recalled the sequence after the 10-min. delay. Scores on the cued recall and recognition trials tended to support their validity as less demanding retrieval tasks. The use of this spatial learning and memory procedure allows finer discriminations among nonverbal memory deficits and may facilitate direct comparisons with scores on verbal memory tasks such as Serial Digit Learning and the California Verbal Learning Test.

The relationship between intellectual ability and adult performance on the Trail Making Test and the Symbol Digit Modalities Test.

Subjects between the ages of 18 and 30 were divided in groups based on their Satz-Mogel Wechsler Adult Intelligence Scale-Revised Full Scale IQs: (a) Borderline (70 to 79); (b) Low Average (80 to 89); (c) Average (90 to 109); (d) High Average (110 to 119); (e) Superior (120 to 129). Each subject was administered the Trail Making Test (Forms A and B) and the written version of the Symbol Digit Modalities Test. A significant effect for IQ emerged. The low ability subjects were, in the main, significantly different from the higher ability subjects. No gender differences were found.

The relationship between intellectual function and adult performance on the Benton Visual Retention Test.

The focus of the investigation was the relationship between intellectual function, as measured by the Satz-Mogel WAIS-R, and performance on the Benton Visual Retention Test. One hundred and twenty subjects, aged 18 to 30 years, were divided, 20 each, by IQ level into groups ranging from Mentally Retarded to Superior. Subjects provided both Number Correct and Error Score performances under conditions of immediate (Administration A, Form C), 15 s delay (Administration D, Form D), 30 m delay (Form E-card 2, 6, and 10), and copy (Administration C, Form C). Significant group differences were evident at all three conditions, primarily at the lower IQ ranges. Performances of the Average, High Average, and Superior IQ groups differed little, suggesting a ceiling effect. Significant decrements is performance under 30 m delay were evident only within the Low Average, Average and Superior IQ groups. Finally, normative performances under Administration C (Copy, Form C) and a quantitative assessment of errors (Administrations A and D) were reported.

The verbal selective reminding test: preliminary data for healthy elderly.

The verbal selective reminding test was administered to sixty independent living well-educated, healthy elderly, aged 65-75. All subjects met exclusion criteria which were designed to ensure that the results were not secondary to deficits in attention, verbal fluency and intellectual function. On selective reminding, the females did significantly better than the males on most dependent measures. Males and females showed a significant decrease from last trial recall to recall following a fifteen minute delay.

California psychological inventory profiles of peer-nominated assertives, unassertives, and aggressives.

Examined the California Psychological Inventory (CPI) profiles of peer-nominated assertives , unassertives , and aggressives . Eighty males from two social fraternities peer-nominated assertives , unassertives and aggressives . The nomination procedure yielded 12 nominees per group. A profile analysis of the CPI indicated that assertives and aggressives were significantly more similar than were assertives and unassertives , and unassertives and aggressives . Results of a subscale analysis indicated that assertives and aggressives were significantly higher on Dominance, Capacity for Status, Sociability, and Social Presence than Unassertives , but were not significantly different from each other on these subscales. Also, assertives were significantly higher on Socialization, Self-Control, and Achievement via Conformance than were aggressives . Finally, assertives were significantly higher on Achievement via Conformance than were unassertives and aggressives . Implications are discussed.

Relationship between contrived in vivo and role-play assertive behavior.

Used a 2 (High or Low Assertive) x 2 (Role-Play or Contrived In Vivo) design to investigate the external validity of role-play (N = 32). The Conflict Resolution Inventory was used as the selection device. Results indicated a positive relationship between self-report scores and role-play behavior. They also indicated that self-report scores were not predictive of behavior in the contrived in vivo condition; moreover, assertion was enhanced in the role-play condition, while the converse occurred in the contrived in vivo condition. The results indicate that generalizations to more naturalistic settings based upon role-play or self-report scores must be made with caution.