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Background: To assess the effect of neurology residency education as trainees advance into independent practice, the American Academy of Neurology (AAN) elected to survey all graduating neurology residents at time of graduation and in 3-year cycles thereafter., Methods: A 22-question survey was sent to all neurology residents completing residency training in the United States in 2007., Results: Of 523 eligible residents, 285 (54.5%) responded. Of these, 92% reported good to excellent quality teaching of basic neurology from their faculty; however, 47% noted less than ideal training in basic neuroscience. Two-thirds indicated that the Residency In-service Training Examination was used only as a self-assessment tool, but reports of misuse were made by some residents. After residency, 78% entered fellowships (with 61% choosing a fellowship based on interactions with a mentor at their institution), whereas 20% entered practice directly. After adjustment for the proportion of residents who worked before the duty hour rules were implemented and after their implementation, more than half reported improvement in quality of life (87%), education (60%), and patient care (62%). The majority of international medical graduates reported wanting to stay in the United States to practice rather than return to their country of residence., Conclusions: Neurology residents are generally satisfied with training, and most entered a fellowship. Duty hour implementation may have improved resident quality of life, but reciprocal concerns were raised about impact on patient care and education. Despite the majority of international trainees wishing to stay in the United States, stricter immigration laws may limit their entry into the future neurology workforce.

Background: Neurophysiologic studies on human and nonhuman primates implicate an orbitofrontal-insular-striatal circuit in high-level regulation of feeding. However, the role of these areas in determining feeding disturbances in neurologic patients remains uncertain., Objective and Methods: To determine brain structures critical for control of eating behavior, we performed a prospective, laboratory-based, free-feeding study of 18 healthy control subjects and 32 patients with neurodegenerative disease. MR voxel-based morphometry (VBM) was used to identify regions of significant atrophy in patients who overate compared with those who did not., Results: Despite normal taste recognition, 6 of 32 patients compulsively binged, consuming large quantities of food after reporting appropriate satiety. All six patients who overate were clinically diagnosed with frontotemporal dementia (FTD), a disorder previously associated with disordered eating, while the nonovereaters were diagnosed with FTD, semantic dementia, progressive aphasia, progressive supranuclear palsy, and Alzheimer disease. VBM revealed that binge-eating patients had significantly greater atrophy in the right ventral insula, striatum, and orbitofrontal cortex., Conclusion: Binge eating can occur despite reported satiety and is associated with damage to a right-sided orbitofrontal-insular-striatal circuit in humans. These findings support a model in which ventral insular and orbitofrontal cortices serve as higher-order gustatory regions and cooperate with the striatum to guide appropriate feeding responses.

Regulatory stability testing requirements for various types of ophthalmic products, including eyedrops, eye ointments, ophthalmic inserts, injections, irrigating solutions, lens washes, and lenses, are not always straightforward. The International Conference on Harmonization (I CH) guidelines do not completely address all of the stability conditions required for these types of pharmaceutical products and medical devices; regulatory agencies around the world still differ on the exact data requirements, storage conditions (especially temperature and humidity conditions), and certain testing methods. These uncertainties make the development of a global ophthalmic product very difficult. This article reviews many of the appropariate internationally recognized, regulatory guidelines and many of the important points to consider in stability studies for new ophthalmic products. Discussions of regulatory experiences and Expert Reports provide insight to common questions frequently asked by regulatory agencies on these types of products.

The stability data requirements for human pharmaceuticals in the European Community (EC) are based on a series of Directive and Regulation requirements and on a series of advisory guidelines that have been developed and adopted through the International Conference on Harmonization (ICH) procedures or, where there is no relevant ICH project, through the Committee for Proprietary Medicinal Products (CPMP). There are relevant requirements that cover new drugs and finished products containing them and also for existing active ingredients and products containing them. The sources of the relevant information and the data requirements are discussed and summarized.

A study conducted in Brisbane, Queensland, assessed homeless youths' knowledge, attitudes and behaviours relating to acquired immunodeficiency syndrome (AIDS). Data obtained from 40 homeless youths aged 15 to 19 years were compared with that from controls. The findings identified a significantly lower level of accurate knowledge of AIDS by the homeless youth on questions related to the transmission of AIDS and on measures to prevent infection. Furthermore, homeless youth exhibited higher levels of at-risk behaviours for the contraction of AIDS. No significant differences regarding attitudes and beliefs about the disease were found. A subgroup of particularly high-risk youth is identified and described. Given the established knowledge deficits, homeless youth were also assessed for educational measures to which they might respond favourably. Implications for future educational programmes are described. It is concluded that homeless youth are comparatively ignorant of AIDS and comparatively at risk of contracting the disease.

A three month old dog with tetanus was treated with antitoxin, antibiotic, a sedative and a muscle relaxant. A pharyngotomy tube was placed to facilitate feeding. The dog recovered after 23 days of therapy.