Influence of menthol on caffeine disposition and pharmacodynamics in healthy female volunteers

Objectives: The present study was undertaken to determine whether a single oral dose of menthol affects the metabolism of caffeine, a cytochrome P 450 1A2 (CYP1A2) substrate, and pharmacological responses to caffeine in people. Methods: Eleven healthy female subjects participated in a randomized, double-blind, two-way crossover study, comparing the kinetics and effects of a single oral dose of caffeine (200 mg) in coffee taken together with a single oral dose of menthol (100 mg) or placebo capsules. Serum caffeine concentrations and cardiovascular and subjective parameters were measured throughout the study. Results: Co-administration of menthol resulted in an increase of caffeine tmax values from 43.6 ± 20.6 min (mean ± SD) to 76.4 ± 28.0 min (P<0.05). The Cmax values of caffeine were lower in the menthol phase than in the placebo phase, but this effect was not statistically significant (P=0.06). (AUG)0-24, (AUC)0-∞, terminal half-life and oral clearance were not affected by menthol. Only nine subjects' cardiovascular data were included in the analysis because of technical problems during the measurements. After caffeine, heart rate decreased in both treatment phases. The maximum decrease in heart rate was less in the menthol phase (-8.9 ± 3.9 beats/min) than in the placebo phase (-13.1 ± 2.1 beats/min) (P = 0.024). There were no statistically significant differences in systolic and diastolic blood pressures between the two treatments. Conclusions: We conclude that a single oral dose of pure menthol (100 mg) delays caffeine absorption and blunts the heart-rate slowing effect of caffeine, but does not affect caffeine metabolism. The possibility that menthol slows the absorption of other drugs should be considered.Dokuz Eylul University Research Foundation (project no: 0909.99.02.16

Measuring Alexithymia via Trait Approach-I: A Alexithymia Scale Item Selection and Formation of Factor Structure

Introduction: It is not clear in the literature whether available instruments are sufficient to measure alexithymia because of its theoretical structure. Moreover, it has been reported that several measuring instruments are needed to measure this construct, and all the instruments have different error sources. The old and the new forms of Toronto Alexithymia Scale are the only instruments available in Turkish. Thus, the purpose of this study was to develop a new scale to measure alexithymia, selecting items and constructing the factor structure. Methods: A total of 1117 patients aged from 19 to 82 years (mean = 35.05 years) were included. A 100-item pool was prepared and applied to 628 women and 489 men. Data were analyzed using Explanatory Factor Analysis, Confirmatory Factor Analysis, and Item Response Theory and 28 items were selected. The new form of 28 items was applied to 415 university students, including 271 women and 144 men aged from 18 to 30 (mean=21.44).Results: The results of Explanatory Factor Analysis revealed a five-factor construct of "Solving and Expressing Affective Experiences,” "External Locused Cognitive Style,” "Tendency to Somatize Affections,” "Imaginary Life and Visualization,” and "Acting Impulsively,” along with a two-factor construct representing the "Affective” and "Cognitive” components. All the components of the construct showed good model fit and high internal consistency. The new form was tested in terms of internal consistency, test-retest reliability, and concurrent validity using Toronto Alexithymia Scale as criteria and discriminative validity using Five-Factor Personality Inventory Short Form. Conclusion: The results showed that the new scale met the basic psychometric requirements. Results have been discussed in line with related studies

SHORT TERM IMPACTS OF RATIONAL PHARMACOTHERAPY COURSE ON THE RATIONAL PRESCRIBING SKILLS OF FOURTH-YEAR STUDENTS OF DOKUZ EYLUL UNIVERSITY MEDICAL FACULTY

Amaç: Bu çalışma ile Dokuz Eylül Üniversitesi Tıp Fakültesi (DEÜTF) Dördüncü SınıfÖğrencilerine 2008/9 (n=129) ve 2009/10 (n=136) Eğitim Dönemi'nde uygulanan Akılcıİlaç Kullanımı (AİK) kursunun AİK becerileri üzerine kısa süreli etkilerinindeğerlendirilmesi amaçlanmıştır.Gereç ve yöntem: AİK kursu, 2008/9 akademik yılından itibaren, DEÜTF dördüncüsınıf müfredatına entegre edildi. Kursta, Dünya Sağlık Örgütü (DSÖ) tarafındanönerilen DSÖ/Groningen Modeli ile uyumlandırılmış eğitim modeli kullanıldı. Kursunetkisini değerlendirmek için öğrencilere kurs öncesi ve sonrası Nesnel Örgün KlinikSınav (NÖKS) uygulandı ve öğrencilerden kurs sonunda geri bildirim alındı. Her ikieğitim döneminde de uygulanan kurs programının aynı olması nedeniyle sonuçlarbirlikte değerlendirildi. NÖKS'ında, öğrencilerin problem çözme adımları (1- Problemitanımlama, 2- Tedavi amaçlarını belirleme, 3- İlaç dışı tedavinin belirlenmesi, 4- Kişiselilaç (K-ilaç) seçimi ve tedavi seçeneklerinin belirlenmesi, 5- K-ilacın hasta içinuygunluğunun değerlendirilmesi, 6- Reçete, 7- Hastanın bilgilendirilmesi a. İlaç kullanımtalimatları, b. İlaç ile ilgili uyarılar, c. Sonraki randevu) 80 puan ile iletişimbecerileri ise 20 puan ile değerlendirildi.Bulgular: Kurs öncesi NÖKS ortalaması 16,1  0,7, iken kurs sonrası NÖKS ortalaması70,9  0,7 puan olarak saptandı (n=265; p<0,0001). Kurs sonrası geri bildirim formudolduran 139 öğrencinin %100,0'ü kursu meslekleri ile ilişkili olarak değerlendirmiş,%95,4'ü kursta edindikleri AİK bilgi ve becerilerini meslek hayatlarında kullanabileceklerinibelirtmiş ve %79,7'si kursu yararlı olarak nitelemiştir.Sonuç: Dördüncü sınıf öğrencilerine uygulanan AİK Kursu, öğrencilerin akılcı ilaçkullanma ve reçete yazma becerilerini olumlu yönde geliştirmiş, öğrenci memuniyetinisağlamıştır. Bununla birlikte, bu verilerin kursun kısa dönem sonuçları olduğu dikkatealınarak akılcı ilaç kullanımı becerisi üzerine kursun uzun süreli etkisi, son sınıföğrencilerimiz ve mezunlarımız ile yapılacak bir araştırmada değerlendirilmelidir.Objective: The aim of the present study was to evaluate the short term impacts of RPTcourse on rational prescribing skills of the fourth-year students in 2008/9 (n=129) and2009/10 (n=136) school year.Material and method: Starting from academic year 2008/9, a five-day rationalpharmacotherapy (RPT) course was entegrated to the curriculum in University ofDokuz Eylul Medical School. The course was organised in the beginning of the fourthyearusing the World Health Organization (WHO)/Groningen model. The impact ofthe RPT course was measured by pre/post-test design by an objective structuredclinical examination (OSCE) for all students. Also, post-course anonymousquestionnaire was performed for evaluation of course by students' feedbacks. Theresults were evaluated together because the course programme in both academic yearswere the same. Problem solving steps (1- definition of the patient's problem, 2-determination of treatment aims, 3- determination of non-pharmacological treatment,4- selection of the personal drug and treatment options, 5- evaluation of drug eligibilityfor patient, 6- evaluation of prescription, 7-giving information for prescribed drugs a.instructions for drug use, b. information about the adverse effects, c. next appointment;total 80 points) and communication skills (20 points) were assessed in the OSCEs.Results: The mean scores of the pre-test and post-test OSCE were 16.1  0.7 and 70.9 0.7, respectively (n=265; p<0.0001). Hundred percent of 139 students who filled thefeedback form declared that the course was related to their job; 95.4% of studentsreported that they would use the skills and knowledge they acquired in the course intheir future carreer and 79.7% found the course useful.Conclusion: The present study demonstrated that the fourth-year medical studentsmarkedly benefited from the RPT course in developing rational prescribing skills andthat the students were satisfied with the course. However, these are the short-termresults of the course, skills of the final year students and alumni should be evaluated toassess long-term impact of RPT course

Mild encephalitis/encephalopathy with a reversible splenial lesion in children

PURPOSE:We aimed to present clinical and radiologic characteristics of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in children.METHODS:Eight children (5 boys and 3 girls; median age, 5.9 years; age range, 8 months to 14.1 years) diagnosed with MERS between September 2015 and June 2017 were included in the study. We reviewed the patient’s data, including demographic characteristics, prodromal and neurologic symptoms, neurologic examination, magnetic resonance imaging and electroencephalography findings, laboratory findings, treatment, and prognosis.RESULTS:Prodromal symptoms were nausea and vomiting (n=6), diarrhea (n=6), and fever (n=3). Initial neurologic symptoms were seizures (n=4), delirious behavior (n=1), drowsiness (n=1), ataxia (n=1), transient blindness (n=2), abnormal speech (n=2), and headache (n=1). Two patients had a suspected infective agent: urinary tract infection caused by Escherichia coli and gastroenteritis caused by rotavirus. Seven patients had type I lesions, comprising characteristic symmetric ovoid (n=6) and band-shaped (n=1) T2-weighted hyperintense lesions at the spenium of corpus callosum, and one patient had type II lesion with additional symmetric posterior periventricular lesions. The lesions were isointense to mildly hypointense on T1-weighted imaging and did not show enhancement. All lesions displayed restricted diffusion. In all patients, neurologic symptoms completely normalized <48 hours from the onset of symptoms without any sequelae.CONCLUSION:MERS has characteristic imaging features and favorable outcome

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels &gt;2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p &lt; 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

A research on hostile attribution bias and parental characteristics of delinquent adolescentes and nondelinquent adolescents.

TEZ8594Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2011.Kaynakça (s. 118-126) var.xv, 141 s. : res., tablo ; 29 cm.The purpose of this research is to predict if delinquent adolescents and nondelinquent adolescents differ in terms of hostile attribution bias and parental characteristics (physical punishment, verbal punishment, parental criminality, parental marriage status). The research has been carried out on 128 male adolescents who have been on trial at Osmaniye Juvenile Court, and 128 male adolescents who have been attending Osmaniye central schools and who have been known for being non-delinquent as reference group. In the research Picture Questionnaire method that had been developed by Aydın (1977) was used as measurement implement. Personal Information Form that had been developed by the researcher, was used to collect data about the parental characteristics. In the research, SPSS 11,5 package software has been used and, T-test, Mann Whitney U test, Chi squarre test, 2X2 factor variance analysis technics have been used to analyse. Statistical meaningfulness has been taken ,05 As the results of the research is studied, meaningful difference has been found between delinquent adolescents and non-delinquent adolescents by the terms of hostile attribution bias, negative intentions attribution bias, personal casuality attribution bias, physical/verbal punishment applied by the parents and parental criminality. No meaningful difference has been found delinquent adolescents and non-delinquent adolescents by the term of parental marriage status. According to being incurred physical and/or verbal punishment parental marriage status, no meaningful difference has been found between the delinquent adolescents and non delinquent adolescents by the terms of hostile attribution bias.Bu araştırmanın amacı; suç işlemiş ergenlerle suça karışmamış ergenleri; düşmanca niyet yükleme yanlılığı ve bazı ailesel özellikler (ailede fiziksel ceza görüp görmeme, sözel ceza görüp görmeme, ailede suçluluk, anne babanın birlikteliği) bakımından farklılaşıp, farklılaşmadığını incelemektir. Araştırmada, araştırma grubunu Osmaniye Çocuk Mahkemesi'nde işledikleri suçlardan dolayı yargılanan 128 erkek ergen, karşılaştırma grubunu ise Osmaniye merkez okullarına devam eden ve suça karışmadığı bilinen 128 erkek ergen ise oluşturmuştur. Araştırmada, ölçme aracı olarak Aydın (1977) tarafından geliştirilen Resim Anketi kullanılmıştır. Ailesel özellikleri hakkında veri toplayabilmek için araştırmacı tarafından geliştirilen Kişisel Bilgi Formu kullanılmıştır. Araştırmada verilerin analizi için SPSS 11.5 paket programı kullanılmış ve veriler; T Testi, Mann Whitney U testi, Ki Kare Testi, 2X2 Faktörlü Varyans Analizi teknikleri kullanılarak çözümlenmiştir. Araştırmada anlamlılık düzeyi .05 olarak belirlenmiştir. Araştırmadan elde edilen bulgular incelendiğinde, suç işlemiş ergenlerle suça karışmamış ergenler arasında; düşmanca niyet yükleme yanlılığı, olumsuz niyet yükleme yanlılığı, kişisel nedensellik yükleme yanlılığı, ebeveynlerinden fiziksel/sözel ceza görüp görmemeleri ve aile bireylerinde suç davranışının görülüp görülmemesi açısından anlamlı farklılaşma olduğu görülmüştür. Suç işlemiş ergenlerle suça karışmamış ergenler arasında anne babalarının birliktelik durumu açısından anlamlı farklılık bulunmamıştır. Ebeveynlerinden fiziksel ceza / sözel ceza görüp görmemeleri ve anne babalarının birliktelik durumlarına göre suç işlemiş ergenlerle suça karışmamış ergenlerin düşmanca niyet yükleme yanlılıkları arasında anlamlı farklılık bulunmamıştır