References1. Burn DJ, Troster AI. Neuropsychiatric complications of medical and surgical therapies for Parkinson's disease.Enhancement of pre-existing artistic talent as well as the emergence of a new artistic tendency has been associated with frontotemporal dementia (FTD) 1,2 but is an unusual finding in Parkinson's disease (PD). 3 Conversely, available case studies and anecdotal reports have shown that PD does not adversely affect the artistic expression of established artists. 4 We present a patient who was diagnosed with PD and started producing a large amount of artistic work several months after an increase in dopamine agonist dose. Although he previously had demonstrated artistic tendencies, his productivity since beginning dopamine agonist therapy presented a striking change. More recently, he also developed sexual disinhibition in both observed behavior in an unstructured setting and on neuropsychological assessment, which was apparently unrelated to medication change.The patient had been diagnosed with PD and started on levodopa/carbidopa with good results 11 years previously. He had always sketched occasionally, but 3 years ago had started continually producing several pastel drawings per week, sometimes two per day. This increase occurred several months after initiation and increase of ropinirole to 8 mg/day and also coincided with a change in social circumstances, including relocation to an assisted living facility where he had more freedom to draw. He carried a sketchbook with him at all times, and approached acquaintances and strangers in public places to show his work. He believed that the medication positively affected his creativity and was unwilling to make dosage changes. Recently, unrelated to any concurrent change in medication, he developed inappropriate social behaviors, including excessive flirting with women on the street and asking residents and staff of his assisted living facility to pose nude for his artwork.Clinical examination was consistent with the diagnosis of idiopathic PD. Neuropsychological evaluation revealed deficits across several cognitive domains, indicative of a mild PD dementia syndrome. He showed subtle but clear behavioral evidence of disinhibition as evidenced on phonemic fluency performance, with initial generation of expletives consistently across three trials.Artistic critiques of the patient's drawings were varied. One artist described his work as showing originality, attitude, and a strong sense of color and kinesthesia. Another believed his artwork was naive and unoriginal but that his output was so voluminous that some pieces were likely to be artistically successful. His work had been shown in several local galleries, and he reported having sold over $2000 worth of work in the past 1.5 years.Another case report has been published of artistic talent developing or emerging in PD. A 55-year-old patient began writing poetry of publishable standard after initiation of treatment. 3 He had never written poetry previously but had family members who were published...

BackgroundAmalgam that is used for dental fillings contains approximately 50% elemental mercury. During dental student training, amalgam is often removed by drilling without the use of water spray and suction, which are protective measures in preventing mercury aerosol. In this study we measured mercury vapor levels in ambient air during amalgam removal as is typically performed in dental training.MethodsMercury vapor levels in ambient air were measured in a dental school laboratory during removal of amalgam fillings from artificial teeth set into a dental jaw simulator. Mercury vapor was measured under three conditions (25 measurements each): with the simultaneous use of water spray and suction, with the use of suction only, and with the use of neither suction nor water spray. These three conditions are all used during dental student training. Results were compared to Alberta occupational exposure limits for mercury vapor in order to assess potential occupational risk to students. Analysis of variance testing was used to compare data obtained under the three conditions.ResultsWhen water spray and suction were used, mercury vapor levels ranged from 4.0 to 19.0 μg/m3 (arithmetic mean = 8.0 μg/m3); when suction only was used, mercury vapor levels ranged from 14.0 to 999.0 (999.0 μg/m3 represents the high limit detection of the Jerome analyzer) (arithmetic mean = 141.0 μg/m3); when neither suction nor water was used, the vapor levels ranged from 34.0 to 796.0 μg/m3 (arithmetic mean = 214.0 μg/m3).ConclusionsThe Alberta Occupational Health and Safety threshold limit value for mercury vapor over an eight-hour time-weighted period is 25.0 μg/m3. The absolute ceiling for mercury vapor, not to be exceeded at any time, is 125.0 μg/m3. When both water spray and suction were used, mercury vapor levels were consistently below this threshold. When suction without water spray was used, mercury vapor levels exceeded the safety threshold 8% of the time. When neither water spray nor suction was used, 36% of the mercury vapor readings exceeded the absolute ceiling value. To maximize safety, dental schools should train students to remove amalgam only while using water spray and high volume suction. Alternatively, students should use appropriate occupational hygiene personal protective equipment during amalgam removals.