Oppositional defiant disorder/conduct disorder co-occurrence increases the risk of Internet addiction in adolescents with attention-deficit hyperactivity disorder

Objectives The aims of this cross-sectional study were to assess the prevalence of Internet addiction (IA) in a clinical sample of adolescents with attention-deficit hyperactivity disorder (ADHD) and to detect the moderating effects of co-occurring oppositional defiant disorder/conduct disorder (ODD/CD) on the association between ADHD and IA. Methods The study group comprised 119 adolescent subjects who were consecutively referred to our outpatient clinic with a diagnosis of ADHD. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was completed by parents, and subjects were asked to complete the Internet Addiction Scale (IAS). Results The IAS results indicated that 63.9% of the participants (n = 76) fell into the IA group. Degree of IA was correlated with hyperactivity/impulsivity symptoms but not with inattention symptoms. As compared to the ADHD-only group (without comorbid ODD/CD), ADHD + ODD/CD subjects returned significantly higher scores on the IAS. Conclusions As adolescents with ADHD are at high risk of developing IA, early IA detection and intervention is of great importance for this group. In addition, adolescents with ADHD + ODD/CD may be more vulnerable to IA than those in the ADHD-only group and may need to be more carefully assessed for IA

Chemoenzymatic polycondensation of a new azomethine phenol derivates

Bu çalışmada, öncelikle fenoksi imin türevli (E)-4-((benzilimino)metil)fenol monomeri kondenzasyon reaksiyonu ile sentezlenmiş ve monomerin kimyasal yapısı UV–Vis, FTIR,1H-NMR, 13C-NMR spektroskopileriyle karakterize edilmiştir. (E)-4-((benzilimino)metil)fenol'ün enzimatik oksidatif polimerizasyonu oksitleyici ajan ve katalizör olarak hidrojen peroksit varlığında HRP kullanılarak oda sıcaklığında değişik çözücü ve fosfat tamponlarında (pH: 3,0 4,0 5,0 6,0) gerçekleştirilmiştir. Optimum şartlar belirlenmiştir. Çalışmalar koyu kahve renkli polimerin, çözücü olarak sulu etanolün kullanıldığı pH: 4 fosfat tamponunda başarılı bir şekilde sentezlendiğini göstermiştir. Poli-(4-((benzilimino)metil)fenol)'ün karakterizasyonu UV–Vis, FT-IR, 1H-NMR, TGA/DTA ve GPC analiz teknikleri ile gerçekleştirilmiştir.Inthisstudy, phenoxy imine derivative of (E)-4-((benzylimino)methyl)phenolmonomer was synthesized by condensation reaction and the chemical structure of themonomer has been characterized by UV–Vis, FT-IR, 1H-NMR, 13C-NMR spectroscopies. Enzymatic oxidative polymerization of (E)-4-((benzylimino)methyl)phenol using horseradish peroxidase (HRP) in the presence of hydrogen peroxide as catalyst and oxidizing agent was carried out in various solvents and phosphate buffers (pH:3, 4, 5, 6) at room temperature. The optimum conditions were determined. Studies have shown that a dark brown polymer was success fully synthesized by utilizing aqueous ethanol as the solvent at pH: 4 phosphate buffer. Characterization of Poly-[4- (benzylimino)phenol] was carried out via UV–Vis, FT-IR, 1H-NMR, TGA/DTA, and GPC analysis techniques

Rapid eye movement dependent central apnea with periodic leg movements

Central sleep apnea is a period of at least 10 s without airflow, during which no ventilatory effort is present. Most of the central apneas occur in Non-Rapid eye movement (NREM) sleep. Central apnea occuring in Rapid eye movement (REM) sleep is extremely rare. We present our patient who had a diagnosis of obstructive sleep apnea in another sleep center since 2003. His Auto Continuous Positive Airway Pressure (CPAP) machine was disrupted so he admitted to our center to renew his machine and for daytime sleepiness while using his machine. The polysomnography revealed central apneas ending with respiratory arousals and periodic leg movements in rapid eye movement (REM) stage. We found no cause for central apneas. The patient benefited from servo ventilator therapy. We present this case as an unusual form of central apnea with the review of the literatures. Even the patients diagnosed as obstructive sleep apnea should be analyzed carefully. The diagnosis and the therapeutic approach may change in the favor of the patient

The utility of neck/thyromental ratio in defining low-risk patients with obstructive sleep apnea in sleep clinics

We aimed to evaluate the importance of neck/thyromental distance in the diagnosis of moderate to severe obstructive sleep apnea (OSA) in sleep clinics. 185 patients (122 males, 63 females) referred to our sleep clinic with OSA symptoms were enrolled to the study. The patients had level-1 polysomnography (PSG). The neck circumference (N), thyromental distance (T), and STOP test were recorded in all patients. Using an obstructive AHI > 15 event/h on PSG as the cut-off, the best N/T ratio to find patients with OSA was calculated with the receiver operator curve analyses. The best cut-off for N/T was chosen as 4.6. We used Modified STOP test: STO-NT test in which P (for hypertension item) was replaced with N/T ratio. N/T ratio > 4.6 was scored as positive. Two positives out of four questions in STO-NT were scored as high risk for OSA. The OSA prevalence was 60 % for AHI > 15. The mean ratio of N/T was significantly different between groups with AHI > 15 and AHI a parts per thousand currency sign 15. N and N/T ratio were moderately correlated with AHI. Sensitivity, specificity, negative predictive value, positive predictive value, and negative likelihood ratio of STOP test for AHI > 15 were 88.5, 28.4, 61.8, 65.4 % and 0.40, whereas 97.3, 23, 85, 65.9 % and 0.12 for STO-NT test, respectively. STO-NT test seems better than STOP test in determining patients who do not likely to have moderate to severe OSA in sleep clinics so can be preferred to decide on therapies other than CPAP in a short time

Pregnancy-Induced Atypic Demyelinating Inflammatory Disease

We report a 34-year-old female patient with the sole medical history of thalassemia minor who presented with multiple sclerosis-like attacks, once after oral contraceptive (OC) use and three times following separate pregnancies. Her first episode began after I month use of OC at the age of 28, when she complained of bilateral blurred vision and confusion, which lasted a couple of days. She had 3 more episodes of dysarthria and right hemiparesis, behavioral change, and confusion, all of which occurred during the first trimester of 3 consecutive pregnancies and her last pregnancy was noticed during the last episode. Her attacks usually lasted a few weeks and resolved partially or completely following medical abortion. Her brain MRIs revealed a peculiar distribution of atypical multiple demyelinating lesions with contrast enhancement and her MRS was consistent with demyelination. Her routine hematological and biochemical laboratory tests were within normal limits other than mild microcytic anemia. A thorough investigation for vasculitis, rheumatologic disorders, infection, and thrombosis was also negative. Her CSF was normal, without oligoclonal bands. Although there is a known tendency to have remissions during pregnancy in demyelinating diseases, as seen in our case, demyelinating lesions may be triggered by hormonal and immunologic changes during pregnancy. (Archives of Neuropsychiatry 2009; 46: 80-3

Pregnancy-induced atypic demyelinating inflammatory disease Gebelikle Tetiklenen Atipik İnflamatuvar Demiyelinizan Hastalιk

We report a 34-year-old female patient with the sole medical history of thalassemia minor who presented with multiple sclerosis-like attacks, once after oral contraceptive (OC) use and three times following separate pregnancies. Her first episode began after I month use of OC at the age of 28, when she complained of bilateral blurred vision and confusion, which lasted a couple of days. She had 3 more episodes of dysarthria and right hemiparesis, behavioral change, and confusion, all of which occurred during the first trimester of 3 consecutive pregnancies and her last pregnancy was noticed during the last episode. Her attacks usually lasted a few weeks and resolved partially or completely following medical abortion. Her brain MRIs revealed a peculiar distribution of atypical multiple demyelinating lesions with contrast enhancement and her MRS was consistent with demyelination. Her routine hematological and biochemical laboratory tests were within normal limits other than mild microcytic anemia. A thorough investigation for vasculitis, rheumatologic disorders, infection, and thrombosis was also negative. Her CSF was normal, without oligoclonal bands. Although there is a known tendency to have remissions during pregnancy in demyelinating diseases, as seen in our case, demyelinating lesions may be triggered by hormonal and immunologic changes during pregnancy. (Archives of Neuropsychiatry 2009; 46: 80-3