Impact of attention-deficit/hyperactivity disorder on the patient and family: results from a European survey

Background

Children with attention-deficit/hyperactivity disorder (ADHD) often experience problems with education, interaction with others and emotional disturbances. Families of ADHD children also suffer a significant burden, in terms of strain on relationships and reduced work productivity. This parent survey assessed daily life for children with ADHD and their families.

Method

This pan-European survey involved the completion of an on-line questionnaire by parents of children (6–18 years) with ADHD (ADHD sample) and without ADHD (normative population sample). Parents were questioned about the impact of their child's ADHD on everyday activities, general behaviour and family relationships.

Results

The ADHD sample comprised 910 parents and the normative population sample 995 parents. 62% of ADHD children were not currently receiving medication; 15% were receiving 6–8 hour stimulant medication and 23% 12-hour stimulant medication. Compared with the normative population sample, parents reported that ADHD children consistently displayed more demanding, noisy, disruptive, disorganised and impulsive behaviour. Significantly more parents reported that ADHD children experienced challenges throughout the day, from morning until bedtime, compared with the normative population sample. Parents reported that children with ADHD receiving 12-hour stimulant medication experienced fewer challenges during early afternoon and late afternoon/early evening than children receiving 6–8 hour stimulant medication; by late evening and bedtime however, this difference was not apparent. ADHD was reported to impact most significantly on activities such as homework, family routines and playing with other children. All relationships between ADHD children and others were also negatively affected, especially those between parent and child (72% of respondents). Parents reported that more children with ADHD experienced a personal injury in the preceding 12 months, including those requiring the attention of healthcare professionals. Although 68% of parents were satisfied with their child's current treatment, 35–40% stated that their child's ADHD symptoms needed to be more effectively treated during the afternoon and evening.

Conclusion

This parent survey highlights the breadth of problems experienced by ADHD children and the impact throughout the day on both activities and relationships. Therefore, there is a need for treatment approaches that take into account the 24-hour impact of the disorder and include all-day coverage with effective medication.     

The AGH score is a predictor of disease-free survival and targeted therapy efficacy after liver transplantation in patients with hepatocellular carcinoma

Background: Liver transplantation(LT) is the “cure” therapy for patients with hepatocellular carcinoma(HCC). However, some patients encounter HCC recurrence after LT. Unfortunately, there is no effective methods to identify the LT patients who have high risk of HCC recurrence and would benefit from adjuvant targeted therapy. The present study aimed to establish a scoring system to predict HCC recurrence of HCC patients after LT among the Chinese population, and to evaluate whether these patients...     

The Hong Kong Society of Rheumatology consensus recommendations for the management of gout

Clinical Rheumatology - Gout is one of the most common noncommunicable diseases in Hong Kong. Although effective treatment options are readily available, the management of gout in Hong Kong remains...     

Offset analgesia: a temporal contrast mechanism for nociceptive information

Temporal filtering of afferent information is an intrinsic component of the processing of numerous types of sensory information. To date, no temporal filtering mechanism has been identified for nociceptive information. The phenomenon of offset analgesia, the disproportionately large decrease in perceived pain following slight decreases in noxious thermal intensity, however, suggests the existence of such a mechanism. To test the hypothesis that a temporal filtering mechanism is engaged during noxious stimulus offset, subjects rated heat pain intensity while stimulus fall rates were varied from -0.5 to -5.0 degrees C/s. In the absence of a temporal filtering mechanism, pain intensity would be expected to decrease in direct proportion to the stimulus fall rate. However, psychophysical fall rates were considerably faster than stimulus fall rates, such that subjects reported no pain while stimulus temperatures were clearly within the noxious range (47.2 degrees C). In addition, paired noxious stimuli were presented simultaneously to determine if offset analgesia evoked by one stimulus could inhibit pain arising from a separate population of primary afferent neurons. Pain ratings were significantly lower than those reported from two constant 49 degrees C stimuli when offset analgesia was induced proximal to, but not distal to, a second noxious stimulus. These asymmetric spatial interactions are not readily explained by peripheral mechanisms. Taken together, these findings indicate that offset analgesia is mediated in part by central mechanisms and reflect a temporal filtering of the sensory information that enhances the contrast of dynamic decreases in noxious stimulus intensity.     

HIV-related oral disease epidemiology among women: year 2000 update

OBJECTIVES: The goals of this literature review were to (1) update a prior review [Shiboski CH (1997) The epidemiology of HIV-related oral manifestations in women: a review. Oral Dis 3: S18–S27] of studies on the epidemiology of HIV-related oral manifestations in women prior to the availability of highly active antiretroviral therapy (HAART); (2) explore the effect of HAART on HIV-related oral disease among women; and (3) explore future research directions with respect to HIV-related oral disease epidemiology among African women.
METHODS: A computer-assisted search was conducted to identify studies on the prevalence of oral conditions in HIV-infected women in relation to immunological markers and HAART [excluding studies reviewed in Shiboski CH (1997) The epidemiology of HIV-related oral manifestations in women: a review. Oral Dis 3: S18–S27]. Results were summarized and discussed for (1) studies conducted in the developed world prior to and during the era of HAART; and (2) studies conducted in sub-Saharan Africa.
RESULTS: Candidiasis (OC) is the most common oral lesion among HIV-infected women, and has been found to be associated with a low CD4 count and a high plasma viral load. Preliminary findings suggest that HAART is associated with a decreasing OC incidence. The few studies identified on HIV-related oral disease in African women suggest that OC is also a common condition in this setting.
CONCLUSION: Future oral epidemiology research efforts in Africa should focus on the potential role of OC as sentinel marker of HIV infection and disease progression, to improve detection and prevention of selected opportunistic illnesses.     

丁基苯酞在大鼠中代谢产物的研究

用放射性同位素的方法研究了丁基苯肽（ＮＢＰ）在大鼠体内代谢，并对代谢产物进行了鉴定。结果表明，大鼠ｉｇ３ＨＮＢＰ后２４ｈ，从尿和粪中排出的放射性分别为ｉｇ剂量的５５２％和１８５％，排除了药物蓄积在体内的可能性；用高效液相色谱法分离、纯化了丁基苯酞的两个主要的体外代谢产物代Ｉ和代Ｉ，根据代Ｉ和代ＩＩ的波谱数据（ＵＶ，１ＨＮＭＲ，ＭＳ）确定了它们的化学结构；薄层色谱（ＴＬＣ）证明丁基苯酞的体内代谢产物同样有代Ｉ和代Ｉ，并且也是两个主要的代谢产物；大鼠ｉｇ３ＨＮＢＰ后１ｈ，脑中原型药与代谢物的比例为１∶１，而且只发现有代Ｉ，未发现有代Ｉ，推测代Ｉ很有可能是活性代谢产物。     

Opioids in the management of pain during delivery

Abstract: Labour and delivery involve severe pain for most women. The goal for pain treatment in obstetrics is to provide effective and safe analgesia during all phases of delivery. The ideal method for pain relief during delivery is not yet available. This thesis aims at studying some aspects of opioids in obstetric pain treatment with respect to analgesic efficacy and side-effects, and to analyse pain during delivery from a neurobiological perspective.