Effect of methylphenidate on auditory event related potential in boys with attention deficit hyperactivity disorder

OBJECTIVE: Event related brain potentials (ERPs) is a non-invasive technique giving knowledge about neural activity associated with sensory and cognitive information processing. The aims of the present study were to investigate amplitude and latency of P100, N200, and P300 in parietal and frontal areas in children with attention deficit hyperactivity disorder (ADHD), and in healthy children, and to determine the effect of methylphenidate (MPH) on these ERPs indices in ADHD group. METHODS: ERP indices, latencies of parietal P3 (PP3L), P1 (PP1L), N2 (PN2L), and frontal P1 (FP1L), N2 (FN2L), P3 (FP3L), and amplitudes of parietal P3 (PP3A), P1 (PP1A), N2 (PN2A), and frontal P1 (FP1A), N2 (FN2A), and P3 (FP3A), using an auditory oddball paradigm were recorded before and under MPH treatment in boys with ADHD, and in 23 healthy children. RESULTS: Before MPH treatment, PP3L was significantly longer and PP3A, PN2A, FN2A, and FP3A smaller in children with ADHD compared to healthy children (all P values < .05). No significant difference was found in PP1L, PP1A, PN2L, FP1L, FP1A, FN2L, and FP3L between ADHD and control group (all P values > .05). MPH treatment resulted in a significant decrease in PP3L, PN2L, and FP3L, and increase in PP3A, PP1A, and FP3A (all P values < .05). There was no significant difference in PP1L, PN2A, FP1L, FP1A, FN2L, and FN2A between before MPH and under MPH treatment in ADHD subjects (all P values > .05). Under MPH treatment, PP3L, PP3A, PP1L, PP1A, PN2L, FP1L, FP1A, FN2L, FP3L, and FP3A were not significantly different between children with ADHD and healthy controls (all P values > .05). However, PN2A and FN2A were significantly smaller in ADHD subjects compared to controls (both P values < .05). CONCLUSION: This study provides indirect evidence that ADHD subjects are associated with abnormalities in signal detection (inattention) and discrimination, and information processing. In addition, present study has shown that except FN2A and PN2A, MPH normalizes ERP indices, which suggested that MPH may be effective on impaired information processing in ADHD, but not on the receiving information.     

Evaluation of central neuropathy in type II diabetes mellitus by multimodal evoked potentials

The electrophysiological results in 51 patients with diabetes mellitus type II were compared with those in 30 age and sex matched healthy control subjects. Peripheral and cortical latencies of median and tibial somatosensory evoked potentials (SEP), bilateral I-III and I-V interpeak latencies (IPL) of brainstem auditory evoked potentials (BAEP), bilateral P100 latency of visual evoked potentials (VEP) and bilateral cortical latency and central motor conduction time of motor evoked potentials (MEP) were evaluated. We observed prolonged latencies suggestive of central neuropathy in DM type II. It has been shown that most of the electrophysiological parameters in patients with DM type II correlate with the duration of the disease, some of them with the age of the patient, and few of them with the onset of the disease. To our knowledge, there is no correlation between the electrophysiological parameters and the level of glycemia or the degree of metabolic control. We conclude that central and peripheral neuropathies in DM are related to the duration of the disease and not to the degree of hyperglycemia and metabolic control.     

Asemptomatic single coronary artery in patient with severe peripheric artery disease

This report describes a 70-year-old patient with single coronary artery, in whom the right coronary artery originated from the distal left circumflex. This patient did not have any other cardiovascular anomaly. However, this patient suffered from severe and proggressive peripheric arterial disease.     

Large mycotic aneurysm of the peroneal artery

We describe the case of a 37-year-old patient with mycotic aneurysm of the right peroneal artery associated with episodes of endocarditis. There are only 7 cases of mycotic aneurysms of the crural arteries reported in the literature. To the best of our knowledge, this is the first reported case of a mycotic aneurysm of the peroneal artery in an adult.     

A novel method for prediction of stone composition: the average and difference of Hounsfield units and their cut-off values

Purpose

The purpose of the study was to investigate the predictive value of stone measurements by including a novel method on non-contrast computed tomography (NCCT) images for stone composition.

Methods

We retrospectively evaluated patients who had stone analysis, NCCT images, and underwent percutaneous nephrolithotomy between 2013 and 2016. Patient characteristics, stone measurements on NCCT images, and stone analysis results were evaluated. Hounsfield unit (HU) values (maximum (HU_max), minimum (HU_min), and average (HU_ave) of HU values) were investigated on NCCT images. HU_diff was calculated as the difference between the HU_max and the HU_min values. Patients were divided into seven stone groups and data were compared. Then patients were separately divided into two groups according to mineral complexity (mono-mineral and multi-mineral groups) and calcium-based (calcium and other stone groups) evaluation.

Results

In the study, 115 patients were evaluated. Age, gender, HU_min, HU_max, and HU_ave were significantly different between the stone groups. HU_diff and HU_ave were found to be 341.5 HU (AUC?=?0.719, p?=?0.017) and 1051.5 HU (AUC?=?0.701, p?=?0.029) as cut-off, respectively. Seventy of 72?>?341.5 HU_diff patients and 64 of 67?>?1051.5 HU_ave patients had multi-mineral stones (p?=?0.001, OR 9.26, and p?=?0.028, OR 4.27), respectively. In multivariate analysis, >?341.5 HU_diff rate was significantly higher in multi-mineral and calcium stone groups; HU_ave was also significantly higher in the calcium stone group.

Conclusions

HU_diff and HU_ave were significant predictors of mineral complexity. HU_diff of <?341.5 HU showed 81.8% sensitivity and 67.2% specificity for identification of mono-mineral stones.

     

An Atropa belladonna L. poisoning with acute subdural hematoma

Atropa belladonna L. is a plant long known to cause poisoning. But no cases of acute subdural hematoma resulting from such poisoning have been reported so far. Care must also be taken in terms of acute pancreatitis and rhabdomyolysis in cases of such poisoning. The plant may sometimes be mistaken for the Caucasian blueberry, V. arctostaphylos L. At least one anti-cholinesterase toxidrome finding was determined in all the nine cases of belladonna poisoning in this series. No elevated creatine kinase was reported in one case with acute subdural hematoma and hyperamylasemia.     

An Adult-Onset Still's Disease with Autoimmune Thyroiditis

Adult-onset Still's disease is a rare inflammatory disorder of unknown etiology and has same clinical charecteristics of the systemic form of juvenile rheumatoid arthritis. A 17 years old white female had arthralgias of multiple joints including small joints of hands. She had fever, rash, hepatosplenomegaly, and CRP-122mg/dl, ESR-91mm in 1st hour. She had also TSH - 6.24μIU/mL, fT3 - 2.1pg/mL, fT4 - 1.36ng/dL and diagnosed as Adult-onset Still's disease with autoimmune thyroiditis. It is an inherited condition and is more common in women than in men.