A Comparison of Risperidone and Buspirone for Treatment of Behavior Disorders in Children with Phenylketonuria

How to Cite This Article: Fayyazi A, Salari E, Khajeh A, Ghajarpour A. A Comparison of Risperidone and Buspirone for Treatment ofBehavior Disorders in Children with Phenylketonuria. Iran J Child Neurol. 2014 Autumn; 8(4):33-38.AbstractObjectiveMany patients with late-diagnosed phenylketonuria (PKU) suffer from severe behavior problems. This study compares the effects of buspirone and risperidone on reducing behavior disorders in these patients.Materials & MethodsIn this crossover clinical trial study, patients with severe behavior disorders after medical examination were randomly divided into two groups of two 8-week crossover treatments with risperidone or buspirone. Patient behavioral disorders before and after treatment by each drug was rated by parents on the Nisonger Child Behavior Rating Form (NCBRF), and after treatment by each drug, were assessed by a physician through clinical global impression (CGI).ResultsThirteen patients were able to complete the therapy period with these two medications.The most common psychiatric diagnoses were intellectual disability accompanied by pervasive developmental disorder NOS, and intellectual disability accompanied by autistic disorder. Risperidone was significantly effective in reducing the NCBRF subscales of hyperactivity disruptive/ stereotypic, and conduct problems. Treatment by buspirone only significantly decreased the severity of hyperactivity, but other behavior aspects showed no significant differences. Assessment of the severity of behavior disorder after treatment by risperidone and buspirone showed significant differences in reducing hyperactivity and masochistic/stereotype.ConclusionAlthough buspirone is effective in controlling hyperactivity in patients with PKU, it has no preference over risperidone. Therefore, it is recommended as an alternative to risperidone.ReferencesSmith I, Nowles JK. Behaviour in early treated phenylketonuria: a systematic review. Eur J Pediatr 2000;159:89-93.Targum SD and Lang W .Neurobehavioral Problems Associated with Phenylketonuria. Psychiatry (Edgemont) 2009; 7(12):29–32.Luciana M, Hanson K L,Whitley C B.A preliminary report on dopamine system reactivity in PKU: acute effects of haloperidol on neuropsychological, physiological, and neuroendocrine functions. Psychopharmacology 2004;175: 18–25.Pappadopulos E, Woolston S, Chait A, Perkins M, Connor DF, Jensen P S. Pharmacotherapy of Aggression in Children and Adolescents: Efficacy and Effect Size. 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J Child Adolesc Psychopharmacol 2006; 16:379–392.Reyes M, Buitelaar J, Toren P, Augustyns I, Eerdekens M. A randomized, double-blind, placebo-controlled study of risperidone maintenance treatment in children and adolescents with disruptive behavior disorders. Am J Psychiatry 2006; 163:402–410.Reyes M, Croonenberghs J, Augustyns I, Eerdekens M. Long-term use of risperidone in children with disruptive behavior disorders and subaverage intelligence: Efficacy, safety, and tolerability. J Child Adolesc Psychopharmacol 2006; 16:260–272.Croonenberghs J, Fegert JM, Findling RL, De Smedt G, Van Dongen S. Risperidone Disruptive Behavior Study Group: Risperidone in children with disruptive behavior disorders and subaverage intelligence: A 1-year, openlabel study of 504 patients. J Am Acad Child Adolesc Psychiatry 2005; 44:64–72.Aman M G, Smedt G D, Derivan A, Lyons B, Findling R L.Double-Blind, Placebo-Controlled Study of Risperidone for the Treatment of Disruptive Behaviors in Children With Subaverage Intelligence. Am J Psychiatry 2002; 159:1337–1346.Snyder R, Turgay A, Aman M, Binder C, Fisman S, Carroll A. Risperidone Conduct Study Group. Effects of risperidone on conduct and disruptive behavior disorders in children with subaverage IQs. J Am Acad Child Adolesc Psychiatry 2002; 41:1026–1036.Gualtieri T. Buspirone for the Behavior problems of patients with Organic Brain Disorders. J Clin Psycopharmacol 1991; 11:280-281.Stanislav S, Fabre T, Crismon L, Childs A. Buspirone’s Efficacy in Organic-Induced Aggression.J Clin Psycopharmacol 1994;14:126-130.Realmuto GM, August GJ, Garfinkel BD. Clinical effect of buspirone in autistic children. J Clin Psychopharmacol 1989; 9(2):122-5.Ratey J, Sovner R, Parks A, Rogentine K. 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Boiling Heat Transfer of Alumina Nano-Fluids: Role of Nanoparticle Deposition on the Boiling Heat Transfer Coefficient

This paper focuses on the thermal performance of alumina nano-fluids during the quenching process of a surface at the boiling condition, which can be a good answer to the controversial results available in the nano-fluid related literature. For this purpose, an experimental study is conducted to investigate the potential application of alumina/water nano-fluid for cooling a stainless steel rod under the flow boiling heat transfer mechanism. Nano-fluids are prepared by dispersing the 5, 50 and 80nm alumina nanoparticles into the deionized water. The experimental facility provides conditions to quantify the heat transfer coefficient in forced convection and nucleate boiling heat transfer domains at different operating conditions. In terms of operating time, the experiments are divided into two domains namely short time study and extended time study. For the short time study (0-60 minutes of study with neglecting the role of time on the deposition of nanoparticles) enhancement of heat transfer coefficient is reported for all nano-fluids, however for nano-fluid with smaller nanoparticle size, higher thermal performance is registered. In extended time study (60-1000 minutes) heat transfer coefficient is found to be considerably deteriorated for all nano-fluids. This work demonstrates that the reason for deterioration of heat transfer coefficient is referred to the surface roughness, nanoparticle size, static contact angle and thermal fouling resistance parameters. These four parameters are simultaneously determinative factors, which strongly control the thermal behaviour of nano-fluids over the extended time and are the exact reasons for the controversies raised in the literature

Boiling Thermal Performance of TiO2 Aqueous NanoFluids as a Coolant on a Disc Copper Block

This work focuses on potential application of nano-fluids in cooling of high heat flux surfaces. For this purpose, experimental studies have been performed to quantify the heat transfer coefficient of Titana (TiO2) aqueous nano-fluids under different operating conditions. Boiling mechanism is established on a disc copper made heater at different heat flux, mass concentration of nano-fluids and sub-cooling temperatures. Results demonstrated that heat transfer coefficient of Titana nano-fluids are relatively higher than that of the base fluid. Heat and mass concentration of nano-particles can intensify the pool boiling heat transfer coefficient, while sub-cooling temperature can only have impacts on bubble formation. Also, visual study demonstrates that fouling formation of nano-particles can intensify the bubble transport due to the intensification of nucleation sites in the boiling surface.

The Relationship between Management Styles and Change and Innovation Skills of Administrators in Teaching Hospitals of Shiraz University of Medical Sciences

Background: With regard to novel plans in the health sector, including “Health Sector Evolution” and changes of hospitals’ issues, change and innovation skills are considered essential for hospital administrators. This study aimed to determine the relationship between management style and change and innovation skills of administrators in Teaching Hospitals of Shiraz University of Medical Sciences in 2009. Methods: This was a cross-sectional and descriptive-analytical survey. Study samples were 9 managers and 135 headquarter staff of hospitals affiliated to Shiraz University of Medical Sciences. Data were collected using the management style questionnaire of Rensis Likert and questionnaire of change and innovation skills. Data were analyzed through SPSS16 and using descriptive statistics (frequency, percentage and mean) and analytical statistics (t-test and ANOVA .( Results: Most hospital administrators of Shiraz University of Medical Sciences had consultative management style. The majority of headquarter staff were in the age group of 20-40 years. There was a significant relationship between change and innovation skills of hospital administrators and their management styles (P<0.001). Conclusion: It seems that in order to implement the change and innovation plans in hospitals, implementing a successful participatory management style is very effective, because with honest participation, the organizational goals will be more achievable. Keywords: Management style, change and innovation skills, hospital administrators, headquarter staf

Anticonvulsant treatments of dysphoric mania: a trial of gabapentin, lamotrigine and carbamazepine in Iran

The treatment of dysphoric mania is challenging given the need to treat symptoms of both depression and mania simultaneously without provoking any clinical exacerbation. The newer antiepileptic drugs such as gabapentin, lamotrogine, and carbamazepine are often used as adjuncts to either lithium or valproic acid in the treatment of bipolar disorder. We decided to undertake a monotherapy trial because previous evidence suggested mixed states may be more responsive to anticonvulsants than more traditional antimanic agents. 51 patients with a DSM IV diagnosis of dysphoric mania were randomized to three groups comprising gapbapentin, lamotrogine or carbamazepine and followed for 8 weeks. Psychiatric diagnosis was verified by the structural clinical interview for the DSM-IV (SCID). The MMPI-2 in full was used to assess symptoms at baseline and 8 weeks. All three groups showed significant changes in MMPI-2 scores for depression and mania subscales. Gabapentin showed the greatest change in depression symptom improvement relative to lamotrogine and carbamazepine, respectively. Although manic symptoms improved overall, here were no differences between groups in the degree of manic symptom improvement

Light-Emitting Diode (LED) therapy attenuates neurotoxicity of methanol-induced memory impairment and apoptosis in the hippocampus

BACKGROUND & OBJECTIVE: The adolescent brain has a higher vulnerability to alcoholinduced neurotoxicity, compared to adult's brain. Most studies have investigated the effect of ethanol consumption on the body, however, methanol consumption, which peaked in the last years, is still poorly explored. METHOD: In this study, we investigated the effects of methanol neurotoxicity on memory function and pathological outcomes in the hippocampus of adolescent rats and examined the efficacy of Light- Emitting Diode (LED) therapy. Methanol induced neurotoxic rats showed a significant decrease in the latency period, in comparison to controls, which was significantly improved in LED treated rats at 7, 14 and 28 days, indicating recovery of memory function. In addition, methanol neurotoxicity in hippocampus caused a significant increase in cell death (caspase3+ cells) and cell edema at 7 and 28 days, which were significantly decreased by LED therapy. Furthermore, the number of glial fibrillary acid protein astrocytes was significantly lower in methanol rats, compared to controls, whereas LED treatment caused their significant increase. Finally, methanol neurotoxicity caused a significant decrease in the number of brain-derived neurotrophic factor (BDNF+) cells, but also circulating serum BDNF, at 7 and 28 days, compared to controls, which were significantly increased by LED therapy. Importantly, LED significantly increased the number of Ki-67+ cells and BDNF levels in the serum and hypothalamus in control-LED rats, compared to controls without LED therapy. CONCLUSION: In conclusion, chronic methanol administration caused severe memory impairments and several pathological outcomes in the hippocampus of adolescent rats which were improved by LED therapy

The inhibitory effect of 6-gingerol and cisplatin on ovarian cancer and antitumor activity: In silico, in vitro, and in vivo

© 2023 Salari, Khosravi, Pourkhandani, Molaakbari, Salarkia, Keyhani, Sharifi, Tavakkoli, Sohbati, Dabiri, Ren and Shafie’ei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/Background: Epithelial ovarian cancer is very common in women and causes hundreds of deaths per year worldwide. Chemotherapy drugs including cisplatin have adverse effects on patients’ health. Complementary treatments and the use of herbal medicines can help improve the performance of medicine. 6-Gingerol is the major pharmacologically active component of ginger. In this study, we compared the effects of 6-gingerol, cisplatin, and their combination in apoptotic and angiogenetic activities in silico, in test tubes, and in in vivo assays against two ovarian cancer cell lines: OVCAR-3 and human umbilical vein endothelial cells (HUVECs). Methods: The drug-treated cell lines were evaluated for their cytotoxicity, cell cycle, and apoptotic and angiogenetic gene expression changes. Results: The proportion of apoptosis treated by 6-gingerol coupled with cisplatin was significantly high. In the evaluation of the cell cycle, the combination therapy also showed a significant promotion of a higher extent of the S sequence. The expression of p53 level, Caspase-8, Bax, and Apaf1 genes was amplified again with combination therapy. Conversely, in both cell lines, the cumulative drug concentrations reduced the expression of VEGF, FLT1, KDR, and Bcl-2 genes. Similarly, in the control group, combination treatment significantly decreased the expression of VEGF, FLT1, KDR, and Bcl-2 genes in comparison to cisplatin alone. Conclusions: The findings of the present study demonstrated that the cisplatin and 6-gingerol combination is more effective in inducing apoptosis and suppressing the angiogenesis of ovarian cancer cells than using each drug alone.Peer reviewe

The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis

Background Osteoporosis affects all sections of society, including families with people affected by osteoporosis, government agencies and medical institutes in various fields. For example, it involves the patient and his/her family members, and government agencies in terms of the cost of treatment and medical care. Providing a comprehensive picture of the prevalence of osteoporosis globally is important for health policymakers to make appropriate decisions. Therefore, this study was conducted to investigate the prevalence of osteoporosis worldwide. Methods A systematic review and meta-analysis were conducted in accordance with the PRISMA criteria. The PubMed, Science Direct, Web of Science, Scopus, Magiran, and Google Scholar databases were searched with no lower time limit up till 26 August 2020. The heterogeneity of the studies was measured using the I2 test, and the publication bias was assessed by the Begg and Mazumdar’s test at the significance level of 0.1. Results After following the systematic review processes, 86 studies were selected for meta-analysis. The sample size of the study was 103,334,579 people in the age range of 15–105 years. Using meta-analysis, the prevalence of osteoporosis in the world was reported to be 18.3 (95% CI 16.2–20.7). Based on 70 studies and sample size of 800,457 women, and heterogenicity I2: 99.8, the prevalence of osteoporosis in women of the world was reported to be 23.1 (95% CI 19.8–26.9), while the prevalence of osteoporosis among men of the world was found to be 11.7 (95% CI 9.6–14.1 which was based on 40 studies and sample size of 453,964 men.). The highest prevalence of osteoporosis was reported in Africa with 39.5% (95% CI 22.3–59.7) and a sample size of 2989 people with the age range 18–95 years. Conclusion According to the medical, economic, and social burden of osteoporosis, providing a robust and comprehensive estimate of the prevalence of osteoporosis in the world can facilitate decisions in health system planning and policymaking, including an overview of the current and outlook for the future; provide the necessary facilities for the treatment of people with osteoporosis; reduce the severe risks that lead to death by preventing fractures; and, finally, monitor the overall state of osteoporosis in the world. This study is the first to report a structured review and meta-analysis of the prevalence of osteoporosis worldwide