Does behavioural inhibition system dysfunction contribute to Attention Deficit Hyperactivity Disorder?

The Reinforcement Sensitivity Theory of Personality has as its main foundation a Behavioural Inhibition System (BIS), defined by anxiolytic drugs, in which high trait sensitivity should lead to internalising, anxiety, disorders. Conversely, it has been suggested that low BIS sensitivity would be a characteristic of externalising disorders. BIS output should lead to increased arousal and attention as well as behavioural inhibition. Here, therefore, we tested whether an externalising disorder, Attention Deficit Hyperactivity Disorder (ADHD), involves low BIS sensitivity. Goal-Conflict-Specific Rhythmicity (GCSR) in an auditory Stop Signal Task is a right frontal EEG biomarker of BIS function. We assessed children diagnosed with ADHD-I (inattentive) or ADHD-C (combined) and healthy control groups for GCSR in: a) an initial smaller study in Dunedin, New Zealand (population ~120,000: 15 control, 10 ADHD-I, 10 ADHD-C); and b) a main larger one in Tehran, Iran (population ~9 [city]-16 [metropolis] million: 27 control, 18 ADHD-I, 21 ADHD-C). GCSR was clear in controls (particularly at 6-7 Hz) and in ADHD-C (particularly at 8-9 Hz) but was reduced in ADHD-I. Reduced attention and arousal in ADHD-I could be due, in part, to BIS dysfunction. However, hyperactivity and impulsivity in ADHD-C are unlikely to reflect reduced BIS activity. Increased GCSR frequency in ADHD-C may be due to increased input to the BIS. BIS dysfunction may contribute to some aspects of ADHD (and potentially other externalising disorders) and to some differences between the ADHD subtypes but other prefrontal systems (and, e.g. dopamine) are also important.

Neurofeedback Training as a New Method in Treatment of Crystal Methamphetamine Dependent Patients: A Preliminary Study.

This study aimed to compare the effectiveness of neurofeedback (NFB) plus pharmacotherapy with pharmacotherapy alone, on addiction severity, mental health, and quality of life in crystal methamphetamine-dependent (CMD) patients. The study included 100 CMD patients undergoing a medical treatment who volunteered for this randomized controlled trial. After being evaluated by a battery of questionnaires that included addiction severity index questionnaire, Symptoms Check List 90 version, and World Health Organization Quality of Life, the participants were randomly assigned to an experimental or a control group. The experimental group received thirty 50-min sessions of NFB in addition to their usual medication over a 2-month period; meanwhile, the control group received only their usual medication. In accordance with this study's pre-test-post-test design, both study groups were evaluated again after completing their respective treatment regimens. Multivariate analysis of covariance showed the experimental group to have lower severity of addiction, better psychological health, and better quality of life in than the control group. The differences between the two groups were statistically significant. These finding suggest that NFB can be used to improve the effectiveness of treatment results in CMD patients.

Respiratory disorders associated with occupational inhalational exposure to bioaerosols among wastewater treatment workers of petrochemical complexes.

BACKGROUND: Workers in wastewater treatment plants are exposed to a wide range of chemicals as well as biological contaminants. OBJECTIVE: To ascertain whether exposure to bio-aerosols under the normal working conditions in wastewater treatment plants is associated with any significant changes in the prevalence of respiratory symptoms and lung function capacities. METHODS: 198 employees of wastewater treatment plants and 99 unexposed persons were studied. American thoracic society (ATS) standard respiratory symptom questionnaire was used to determine the prevalence of respiratory symptoms. Pulmonary function tests were conducted for each participant. RESULTS: The prevalence of respiratory symptoms among exposed persons was significantly higher than that of unexposed people. Mean values of most pulmonary function test parameters were significantly lower in the exposed compared to the comparison group persons. CONCLUSION: Increased prevalence of respiratory symptoms and decrements in pulmonary function test parameters may be attributed to exposure to bio-aerosols released from wastewater treatment plants.

Comparison of anger management, anxiety and perceived stress in patients with cancer and Coronary Heart Disease (CHD).

The present study was conducted with the aim of studying the comparison of anger management, anxiety and perceived stress in patients with cancer and Coronary Heart Disease (CHD). The two groups of subjects consisted of patients with cancer (n = 120) and patients with CHD (n = 118) who were selected by using a convenience sampling method and by the employment of Spielberger's State-Trait Anger Expression, Costello and Camry Depression and Anxiety scale and Perceived Stress Scale of Cohen, Kamarak and Mermelstein. In order to analyze the data, after the calculation of descriptive statistics and correlation coefficients, MONOVA was employed to test the hypotheses. The findings indicated that patients with CHD regulate the excitement by externalizing anger and patients with cancer control this excitement by internalizing anger. Moreover, stress and depression in patients with CHD were greater than in patients with cancer. The findings were explained by the employment of the theoretical patterns of the mediating role of personality and regulation of excitement in stress and illness.

Enhanced oxidative stress in Hashimoto's thyroiditis: inter-relationships to biomarkers of thyroid function.

OBJECTIVES: Oxidative stress has been implicated in the pathogenesis of several inflammatory and immune-mediated disorders including Hashimoto's thyroiditis (HT). The objectives of the present cross-sectional investigation were to estimate serum glutathione (GSH) status and the activities of its recycling enzymes in HT and to explore their interrelationships with biomarkers of autoimmunity and thyroid function. DESIGN AND METHODS: Newly diagnosed females with HT (n=44) and 58 matched control subjects were recruited. Thyroid hormone profile, anti-thyroperoxidase anti-body (TPO-AB), anti-thyroglublin antibody (Tg-AB), thyroid volume (Tvol), urinary iodine excretion (UIE), GSH and the activities of glutathione peroxidase (GPx), glutathione reductase and gamma-glutamyltransferase were assessed. RESULTS: Median UIE in HT was slightly but not significantly higher than that of controls. HT group exhibited higher levels of TSH, TPO-AB, Tg-AB and larger Tvol when compared with controls (P<0.001). The means of GSH and GPx in HT patients were significantly different from those of controls (P<0.001). In HT subjects, significant associations were seen between Tvol on TSH, GSH on TPO-AB, GSH on TSH and TPO-AB titers on TSH, respectively. CONCLUSIONS: This is the first study to demonstrate a substantial reduction in GSH status in HT subjects. Secondly, the interrelationship between the GSH contents and TPO-AB titers in HT provides a preliminary data to support the notion that GSH diminution is a hallmark of in the events leading to oxidative stress activation and the development of immunological intolerance in HT. Further studies are required to elucidate the role of GSH in the etiology of down-regulation of thyroid function.

Evaluation of Accessibility of Iodinated Salt and Nutritional Iodine Status during Pregnancy.

BACKGROUND: To assess accessibility of iodinated salt and urinary iodine concentrations (UIC) during pregnancy. This cross-sectional study was carried out between October and December, 2009 in Urmia County, West Azerbaijan (WA), Iran. METHODS: Data on demographic characteristics and iodinated salt accessibility were gathered through a questionnaire at 1st trimester. Household salt samples and urine samples (1st -and 3rd trimesters) were analyzed for iodine content. Pregnant women (n=490) at 1st trimester were interviewed. Of these, 490 subjects (12 prenatal care centers) were enrolled. RESULTS: All participants declared that they were exclusive users of iodinated salt. Segregation of the household salt samples according to iodine content (0, 8, 15 and 30 ppm) revealed that the respective distributions were 3.3%, 1.4%, 23.7% and 71.6%. Median UIC levels at 1st and 3rd trimesters were 73.5 µg/L and 114µg/L respectively. Accordingly, 86% and 70% of participants exhibited UIC < 150 µg/L. CONCLUSION: Median UIC during pregnancy in WA is markedly lower than those previously reported for regions with adequate iodine status in the country. Thus, extra iodine is needed to maintain adequate iodine store during gestation. In addition, this preliminary study reveals that a significant proportion (28%) of the household salt samples had low iodine content (≤ 15 ppm) although a level (>20 and <40 ppm) is mandatory in Iran. Further studies are deemed necessary to elucidate the cause(s) for manifestation iodine deficiency among pregnant women despite 20 years after iodine fortification strategy.

The role of antibiotic prophylaxis in the new era of immunosuppression.

Despite significant improvements in renal transplantation (RTX), certain basic issues remain unresolved such as the routine use of perioperative antibiotic prophylaxis (PAP). To address the need for PAP, we retrospectively evaluated the clinical course of 349 consecutive RTX patients who did not receive any PAP except for Bactrim. Of the 349 transplant recipients, 77% received induction therapy with low-dose rabbit antithymocyte globulin (rATG) and the others were treated with basiliximab. All patients received triple immunosuppression with tacrolimus, mycophenolic acid, and prednisone. Seven patients (2%) developed wound infections. Wound infections were more common in obese and older patients. All wound infections were superficial and responded well to wound drainage and outpatient antibiotic therapy. Six patients (1.7%) experienced a urinary tract infection (UTI) within the first postoperative month. UTIs were more common in the patient with ureteral stent compared to nonstented patients (11.4% vs 0.3%, P<.001). No patient or graft was lost due to perioperative bacterial infections (PBI). Our study shows that despite many predisposing factors, PBI are rare following RTX even in the absence of PAP. Therefore, in order to avoid emergence of multiantibiotic-resistant pathogens, excessive costs, and antibiotic-related adverse events, we suggest that PAP should be used only in selected circumstances such as in recipients older than 60 or when the body mass index is greater than 35.

The effect of preparation design on the fracture resistance of zirconia crown copings (computer associated design/computer associated machine, CAD/CAM system).

OBJECTIVE: One of the major problems of all ceramic restorations is their probable fracture against the occlusal force. The aim of the present in-vitro study is was to compare the effect of two marginal designs (chamfer & shoulder) on the fracture resistance of zirconia copings, CERCON (CAD/CAM). MATERIALS AND METHODS: This in vitro study was done with single blind experimental technique. One stainless steel dye with 50' chamfer finish line design (0.8 mm depth) was prepared using milling machine. Ten epoxy resin dyes were made, The same dye was retrieved and 50' chamfer was converted into shoulder (1 mm).again ten epoxy resin dyes were made from shoulder dyes. Zirconia cores with 0.4 mm thickness and 35 µm cement Space fabricated on the 20 epoxy resin dyes (10 samples chamfer and 10 samples shoulder) in a dental laboratory. Then the zirconia cores were cemented on the epoxy resin dyes and underwent a fracture test with a universal testing machine (GOTECH AI-700LAC, Arson, USA) and samples were investigated from the point of view of the origin of the failure. RESULT: The mean value of fracture resistance for shoulder margins were 788.90±99.56 N and for the chamfer margins were 991.75±112.00 N. The student's T-test revealed a statistically significant difference between groups (P=0.001). CONCLUSION: The result of this study indicates that marginal design of the zirconia cores effects on their fracture resistance. A chamfer margin could improve the biomechanical performance of posterior single zirconia crown restorations. This may be because of strong unity and round internal angle in chamfer margin.

Relevance of complement fixing antinuclear antibodies.

BACKGROUND: Connective tissue diseases (CTDs) are a heterogeneous group of disorders defined by the association of a variety of clinical manifestations with immunologic and other laboratory findings. Overlap of syndromes and aberrant findings appear rather frequently. METHODS: Sera of eight antinuclear antibody (ANA) negative, cases of subacute cutaneous lupus erythematosus (SCLE) with antibodies to Ro (SS-A) and a ninth case with clinical and laboratory signs of Sjögren's syndrome and systemic lupus erythematosus (SLE) were tested for complement (C') fixing antinuclear antibodies (C-ANAs). The ninth case was examined in depth by direct immunofluorescence (DIF) and a two-step "C + DIF" test of biopsies for C' fixation to in vivo bound ANAs, as well as serum tests for C-ANA, ANA, and SCLE markers. RESULTS: Sera of five of the eight ANA negative, Ro(SS-A) positive SCLE cases had C-ANAs. The ninth case, a 50-year-old woman with clinical and laboratory signs of Sjögren's syndrome and SLE, gave a strong positive C + DIF reaction in the skin biopsy for in vivo bound ANAs that fix C', but negative ANAs and C-ANAs in routine serum tests; they revealed antimitochondrial antibodies. Serum tests on normal skin, however, revealed weak ANA and strong C-ANA reactions with in vitro fixed C'. CONCLUSIONS: ANA negative cases of SCLE or Sjögren's syndrome may have C-ANAs. A case with Sjögren's syndrome and signs of SLE had both in vivo and in vitro C' fixing ANAs. C-ANA tests can aid in the identification of such cases.

Chronic ulcerative stomatitis with stratified epithelium-specific antinuclear antibodies.

BACKGROUND: In 1990 a new disease-associated antinuclear antibody was first recognized as a specific immunologic marker for a chronic form of ulcerative stomatitis (CUS). METHODS: Another case is reported herein and the subject of chronic ulcerative stomatitis with stratified epithelium-specific antinuclear antibodies (SES-ANA) is reviewed. Intraoral biopsies from this patient were submitted for microscopic examination and direct immunofluorescence. Indirect immunofluorescence studies were also performed. Serial SES-ANA titers were obtained with the patient on maintenance treatment with hydroxychloroquine. A skin biopsy of a recent lichenoid eruption was obtained and skin explants grown in the serum of this patient were studied in tissue culture with reference to SES-ANA binding and complement fixation. RESULTS: Biopsy and serum studies confirmed a diagnosis of CUS with SES-ANA in the patient reported. Skin biopsy showed lichen planus. The patient was treated with hydroxychloroquine with a favorable response. Serial SES-ANA titers did not parallel the disease activity. Among the substantive observations made from skin explants cultured in the serum of this patient was widespread fixation of C3 to the nuclei of basal cells. CONCLUSIONS: The case described herein extends the findings in CUS to include lichenoid skin lesions. Records show that at least four of 11 cases of CUS had skin lesions, whereas all had oral lesions. Stratified epithelium-specific antinuclear antibodies serve as the key marker of CUS. Skin explants grown in the serum of this CUS patient bind SES-ANA in tissue culture. Sections of explants fix complement. Titers of SES-ANA have been reported to parallel disease activity in one case, but not in the present case. Thus, there appears to be case-to-case variation. The treatment of choice for CUS is hydroxychloroquine.

Quantitative studies of immunofluorescent staining. VII. Quantitative reference standard slide for standardization of fluorescence microscopes.

We evaluated a quantitative reference standard (QRS) slide with 10-microns beads with different concentrations of Coulter Electronics green dye No. 1. Microfluorospectrophotometric readings of the QRS slides provided quantitative comparisons between the sensitivity of the different fluorescence microscopes. The visual comparisons between beads with a range of intensities of fluorescence of Coulter Electronics green dye No. 1 indicated that the end points vary with different optical systems as do the end points in standard indirect immunofluorescent titrations. Fluorescent emission wavelength of QRS slide beads gave the same peak as fluorescein-labeled beads; both differed from the peak of orange beads of an 'Optical Standard' slide. Since shelf life studies show no changes in fluorescence intensity of beads over a period of 27 months or longer, QRS slide beads can afford a device for standardization of fluorescence microscopes used for immunofluorescent tests.