Attention-deficit/hyperactivity disorder medication and seizures

OBJECTIVE: Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of seizures, but there is uncertainty about whether ADHD medication treatment increases risk among patients with and without preexisting seizures. METHODS: We followed a sample of 801,838 patients with ADHD who had prescribed drug claims from the Truven Health MarketScan Commercial Claims and Encounters databases to examine whether ADHD medication increases the likelihood of seizures among ADHD patients with and without a history of seizures. First, we assessed overall risk of seizures among patients with ADHD. Second, within-individual concurrent analyses assessed odds of seizure events during months when a patient with ADHD received ADHD medication compared with when the same individual did not, while adjusting for antiepileptic medications. Third, within-individual long-term analyses examined odds of seizure events in relation to the duration of months over the previous 2 years patients received medication. RESULTS: Patients with ADHD were at higher odds for any seizure compared with non-ADHD controls (odds ratio [OR] = 2.33, 95% confidence interval [CI] = 2.24-2.42 males; OR = 2.31, 95% CI = 2.22-2.42 females). In adjusted within-individual comparisons, ADHD medication was associated with lower odds of seizures among patients with (OR = 0.71, 95% CI = 0.60-0.85) and without (OR = 0.71, 95% CI = 0.62-0.82) prior seizures. Long-term within-individual comparisons suggested no evidence of an association between medication use and seizures among individuals with (OR = 0.87, 95% CI = 0.59-1.30) and without (OR = 1.01, 95% CI = 0.80-1.28) a seizure history. CONCLUSIONS: Results reaffirm that patients with ADHD are at higher risk of seizures. However, ADHD medication was associated with lower risk of seizures within individuals while they were dispensed medication, which is not consistent with the hypothesis that ADHD medication increases risk of seizures

Evaluation of [99mTC(CO)3]-labeled ERBB-2-targeting peptides for breast carcinoma imaging [abstract]

The purpose of this study was to radiolabel a novel ErbB-2-avid peptide, discovered from bacteriophage display, with [99mTc(H2 O)3 (CO)3 ]+ and evaluate the in vitro cellular targeting and in vivo tumor imaging properties of the peptide in a mouse model of human breast cancer

Fish Assemblages on a Mitigation Boulder Reef and Neighboring Hardbottom

We compared the fish assemblages on a mitigation site to neighboring natural habitat. Artificial reefs made of limestone boulders were deployed offshore Florida in August–September 2003 as mitigation for an anticipated nearshore hardbottom burial associated with a planned beach nourishment. Boulders comprising a footprint of 36,017 m2 were deployed on sand substrate, adjacent to hardbottom, to replace an expected covering of 30,756 m2 hardbottom. Nourishment of the beach was initiated May 2005 and completed in February 2006. Fishes on the artificial mitigation reefs and neighboring natural hardbottom were counted annually in August, 2004 through 2008, with 30-m belt transects and rover-diver surveys. Across all surveys a total of 18,313 fish of 185 species was counted. Mean species richness and abundance were typically greater on the transects at mitigation reefs than on nearshore hardbottom (NHB). MDS plots of Bray–Curtis similarity indices show a clear distinction between the mitigation reefs and NHB fish assemblages regardless if the data were, or were not, standardized to account for rugosity differences. SIMPER analysis indicated the two assemblages had, on average, 75% dissimilarity. Thus, while the mitigation boulders exhibited greater abundance and species richness than the NHB, the two assemblages differed dramatically in structure. The mitigation reefs provided a habitat suitable for fish colonization. However, this habitat differed dramatically in size and appearance from impacted NHB and created a unique environment unlike the NHB. Thus, mitigation reefs in general, and boulder reefs specifically, should not be relied upon to provide an equitable replacement to NHB habitat loss

Presence of Juvenile Blackfin Snapper, Lutjanus buccanella, and Snowy Grouper, Epinephelus niveatus, on Shallow-water Artificial Reefs

The inshore environment of Broward County, Florida consists of three reef tracts, each separated by sand substrate, running parallel to the coastline in sequentially deeper water. A wide variety of artificial reef designs have been deployed in Broward County, many lying in sand flats between the reeftracts. From 1995 through 2002, over 1,100 visual fish censuses (predominantly point-counts) were completed on the three natural reeftracts in water depths from 3 m to 30 m and over 1,100 censuses were done on artificial reefs at depths of 7 m to 23 m. Curiously, the juvenile stages of two deeper-water species of the snapper/grouper complex, the blackfin snapper (Lutjanus buccanella) and the snowy grouper (Epinephelus niveatus), appear to prefer artificial reefs located in the sand flat separating the second and third reeftracts to nearby natural reef areas. Five hundred and forty blackfin snapper have been recorded in 64 visual censuses and nine snowy grouper have been observed in seven counts on artificial reefs. Despite the large volume of visual census data collected thus far, these two species have never been recorded on nearby natural reef tracts. The reasons for this unanticipated observation is unclear but it provides an excellent launch-point for an examination of juvenile habitat requirements, natural availability of these requirements, and the potential for artificial substrate to be used in managing these species

Aquatic biosurvey of the Lovell River on UNH land

We assessed the physical, chemical and biological conditions at two sites along the Lovell River on University of New Hampshire (UNH) -owned conservation land. The discharge was 4.4 m3 s-1 at Site 1 and 5.7 m3 s -1 downstream at Site 2. Canopy coverage ranged from 8-25%. Canopy was dominated by Eastern Hemlock (79-84%). Much of the stream was strewn with large boulders and the substrate consisted of rocks of highly variable sizes ( 3-549 cm dia.). Specific conductivity (22.1-23.3 µS), pH (6.4) and temperature (7.9-8.3 °C) varied little between sites. Macro-invertebrate bio-indices indicated either excellent water quality with no apparent organic pollution (3.0/10) or good water quality with possible slight organic pollution (4.4/10)

Fish Colonization of a Newly Deployed Vessel-reef off Southeast Florida: Preliminary Results

Fish colonization on the Ebenezer II, a 25.5m merchant marine vessel, was studied from May 2002 - July 2003. The ship was scuttled in May 2002 off Broward County, Florida at a depth of 21m and was censused 10 times during the study period using a modified Bohnsack and Bannerot visual census method. Adjacent natural reefs and the Mcallister, a nearby, 30m tugboat deployed in June 1998, were censused during the same period. Distinct changes in the fish assemblage on the Ebenezer II were observed throughout the sample period. A pioneer assemblage was observed during the first three months, characterized by the settlement of juvenile fishes «5 cm). Subsequently, numbers of juveniles decreased either through emigration, predation or growth. Resident species made up 52.5% of the total abundance but transient fish species made up 78% of the total fish biomass during the study period. Surprisingly, attraction of adult fish from both natural reefs and the Mcallister was not a major factor in assemblage fonnation. The primary adult fishes attracted to the Ebenezer II were herbivores. These fishes steadily increased in abundance throughout the study period, presumably due to increased food availability as benthic algal communities developed. A similar trend of increasing herbivores with increasing soak time was observed on the Spiegel Grove, a 153m vessel-reef sunk off Key Largo in May 2002. The fish assemblages on the artificial reefs were more similar to each other than to natural reefs. Vessel-reefs had sixty species in common, while the Ebenezer II only had thirty-nine species in common with natural reefs. Several species common to vessel-reefs were absent or rare on nearby natural reefs. This may indicate that vessel-reefs are providing early juvenile and adult habitat that is not available on natural reefs

Appropriateness of unscheduled hospital admissions from care homes

Unscheduled hospital admissions from care homes are common and potentially avoidable but little guidance is available as to what constitutes an appropriate hospital admission. We surveyed healthcare professionals’ opinions on a range of common scenarios affecting care-home residents. We developed seven clinical vignettes and an accompanying questionnaire. We used purposive sampling to obtain opinions from relevant primary care and secondary care teams. We asked assessors to comment on whether they would favour hospital admission and to justify their response using pre-selected options and/or free text. Admission to hospital was judged inappropriate in 54.6% of responses. Opinion on admission varied according to the case, with fewer than half of respondents agreeing for three of the seven cases. Recurring themes were uncertainty around services available to care homes and anticipatory care planning. The lack of consensus suggests that concepts surrounding inappropriate care-home admission are not shared by staff who provide care for this patient group

Hypersensitivity reactions to human papillomavirus vaccine in Australian schoolgirls: retrospective cohort study

Objective To describe the outcomes of clinical evaluation, skin testing, and vaccine challenge in adolescent schoolgirls with suspected hypersensitivity to the quadrivalent human papillomavirus vaccine introduced in Australian schools in 2007

Neuro-ophthalmologic and blood biomarker responses in ADHD following subconcussive head impacts: a case–control trial

IntroductionThis clinical trial aimed to determine the influence of attention-deficit/hyperactivity disorder (ADHD) on neuro-ophthalmologic function and brain-derived blood biomarkers following acute subconcussive head impacts.MethodsThe present trial consisted of age- and sex-matched samples with a ratio of 1:1 between two groups with a total sample size of 60 adults (age ± SD; 20.0 ± 1.8 years). Soccer players diagnosed with and medicated daily for ADHD were assigned into an ADHD group (n = 30). Soccer players without ADHD were assigned into a non-ADHD group (n = 30). Participants performed 10 soccer headers with a soccer ball projected at a velocity of 25mph. King-Devick test (KDT), near point of convergence (NPC), and serum levels of NF-L, tau, GFAP, and UCH-L1 were assessed at baseline (pre-heading) and at 2 h and 24 h post-heading.ResultsThere were no statistically significant group-by-time interactions in outcome measures. However, at baseline, the ADHD group exhibited lower neuro-ophthalmologic functions compared to the non-ADHD group (NPC: p = 0.019; KDT: p = 0.018), and persisted at 2 h-post (NPC: p = 0.007; KDT: p = 0.014) and 24 h-post heading (NPC: p = 0.001). NPC significantly worsened over time in both groups compared to baseline [ADHD: 2 h-post, 1.23 cm, 95%CI:(0.77, 1.69), p < 0.001; 24 h-post, 1.68 cm, 95%CI:(1.22, 2.13), p = 0.001; Non-ADHD: 2 h-post, 0.96 cm, 95%CI:(0.50, 1.42), p < 0.001; 24 h-post, 1.09 cm, 95%CI:(0.63, 1.55), p < 0.001]. Conversely, improvements in KDT time compared to baseline occurred at 2 h-post in the non-ADHD group [−1.32 s, 95%CI:(−2.55, −0.09), p = 0.04] and at 24 h-post in both groups [ADHD: −4.66 s, 95%CI:(−5.89, −3.43), p < 0.001; Non-ADHD: −3.46 s, 95%CI:(−4.69, −2.23), p < 0.001)]. There were no group-by-time interactions for GFAP as both groups exhibited increased levels at 2 h-post [ADHD: 7.75 pg./mL, 95%CI:(1.41, 14.10), p = 0.019; Non-ADHD: 7.91 pg./mL, 95%CI:(1.71, 14.14), p = 0.015)] that returned to baseline at 24 h-post. NF-L levels increased at 2 h-post heading in the ADHD group [0.45 pg./mL, 95%CI:(0.05, 0.86), p = 0.032], but no significant NF-L changes were observed in the non-ADHD group over time.DiscussionTen soccer headers elevated GFAP levels and NPC impairment in both groups. However, persisting group difference in NPC, blunted KDT performance, and increased NF-L levels in the ADHD group suggest that ADHD may reduce neuro-ophthalmologic function and heighten axonal response to soccer headers.Clinical trial registrationClinicalTrials.gov, identifier ID: (NCT04880304)