The Neuropathology of Internet Addiction

"Internet addiction" refers to excessive Internet use that causes significant psychological and social disturbance along with functional impairment. The etiology of Internet addiction is controversial. It has been classified within addictive behaviors and impulse control disorders and it is suggested that trait impulsivity could be used as a marker for predisposition to Internet addiction disorder (IAD). A number of studies have suggested that patients with IAD demonstrated impaired error-monitoring ability compared to healthy controls. IAD is associated with impaired executive control, which is linked to the inability to inhibit brain activation. The mesolimbic reward system is thought to play a crucial role in the development and maintenance of substance use disorders. It was shown that enhanced reward sensitivity and decreased loss sensitivity are correlated with IAD compared to healthy controls. Neuroimaging studies reveal structural changes in the brain of individuals with IAD. Microstructural evidence in gray and white matter obtained from studies further reveal the underlying neural mechanisms of IAD. A variety of gene polymorphisms have been found to be associated with predisposition to IAD. Evidence is still limited in this area and further research is needed to better understand the neuropathology of Internet addiction. © 2016 Elsevier Inc. All rights reserved

Prevalence, Awareness, Treatment and Control of Hypertension in Adults with Chronic Kidney Disease in Turkey: Results From the Credit Study

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What is the optimal dwell time for maximizing ultrafiltration with icodextrin exchange in automated peritoneal dialysis patients?

PubMedID: 16722026? Background: Icodextrin is increasingly being used in automated peritoneal dialysis (APD) for the long dwell exchange to maintain adequate ultrafiltration (UF). However, the UF reported in the literature varies with different dwell times: from 200 to 500 mL with 12 - 15 hour dwells. In order to maximize UF, it is important to know the relationship between dwell time and UF when using icodextrin in APD patients. With this knowledge, decisions can be made with respect to dwell period, and adjustments to the dialysis prescription can be made accordingly. ? Methods: We prospectively studied this relationship in 36 patients from Canada and Turkey. All patients did the icodextrin day exchange manually after disconnecting themselves from overnight cycler dialysis. Dwell period was increased by 1 hour every week, from 10 to 14 hours. Ultra-filtration was noted for each icodextrin exchange. Mean UF for each week (i.e., dwell period) was compared by repeated measures ANOVA. ? Results: We found no difference in mean UF with increasing dwell time: 351.73 ± 250.59 mL at 10 hours versus 371.75 ± 258.25 mL at 14 hours (p = 0.83). We also compared mean UF between different subgroups and found that males (p = 0.02 vs females) and high transporters (p = 0.04 vs low) had higher mean UF. Further analysis of maximal UF showed no correlation to age, sex, diabetic status, transport category, creatinine clearance, Kt/V, duration on peritoneal dialysis, or duration of icodextrin use. ? Conclusion: Icodextrin-related UF in APD patients is not related to demographic factors and does not increase significantly beyond 10 hours. © 2006 International Society for Peritoneal Dialysis

Arm circumference: Its importance for dialysis patients in the obesity era

PubMed ID: 22752452Purpose: The purposes of this study were to investigate the association between arm circumference and body mass index (BMI) and to discuss problems, mainly arm circumference and cuff size mismatch, that could affect the reliability of home blood pressure monitoring (HBPM) among peritoneal dialysis (PD) and hemodialysis (HD) patients. Methods: 525 PD and 502 HD patients from 16 centers were included in the study. A two-part questionnaire was used to gather information from the participants. Arm circumferences were categorized into four groups according to the British Hypertension Society cuff size recommendations. Results: Mean BMI and arm circumference of all participants were 25.0 kg/m2 and 27.6 cm, respectively. There was a significant correlation between BMI and arm circumference. The mean BMI and arm circumference values were higher in PD patients than in HD patients. Requirement of a large-sized adult cuff was more common among PD patients compared to HD patients (14 % vs 8 %, p = 0.002). Conclusions: Since HBPM is a useful tool for clinicians to improve BP control, nephrologists should be aware of the problems related to HBPM in dialysis patients and take an active role to increase the reliability of HBPM. © 2012 Springer Science+Business Media, B.V