A randomized and controlled clinical study was performed to evaluate the use of neurofeedback (NF) to treat attention-deficit/hyperactivity disorder (ADHD) in children and adolescents.
The ADHD ...population was selected from an outpatient clinic for Child and Adolescent Mental Health in Norway. Ninety-one of the 275 children and adolescents ranging in age from 6 to 18 years (10.5 years) participated in 30 sessions of an intensive NF program. The reinforcement contingency was based on the subjects' production of cortical beta1 activity (15-18 Hz). The ADHD participants were randomized into three groups, with 30 in the NF group, 31 controls in a group that was given methylphenidate, and 30 in a group that received NF and methylphenidate. ADHD core symptoms were reported by parents using the parent form of the Clinician's Manual for Assessment by Russell A. Barkley.
Ninety-one children and adolescents were effectively randomized by age, sex, intelligence and distribution of ADHD core symptoms. The parents reported significant effects of the treatments, but no significant differences between the treatment groups were observed.
NF was as effective as methylphenidate at treating the attentional and hyperactivity symptoms of ADHD, based on parental reports.
Current Controlled Trials NCT01252446.
Summary
Thirty days before expected time of parturition, 20 Holstein cows were divided into −Cr and +Cr groups. From day 25 before parturition (BP) up to day 30 after parturition (AP), +Cr cows ...received 10 mg of Cr (chromium‐enriched yeast) daily. Muscle and adipose tissue samples were taken at days −30, −10, +7 and +10 related to parturition, when body condition score (BCS) was also determined. Hepatic tissue samples were taken at days −10 and +7. Tissue samples were used for determination of the insulin signalling pathway protein expressions. Intravenous glucose tolerance test (IVGTT) was performed at days −28, −7, +10 and +30. Milk yield was recorded during first 14 weeks AP. Milk composition was obtained at days 7 and 28 AP. At day 10 BP, protein content of β‐subunit of insulin receptor (IRβ) was significantly higher (p ˂ 0.05) in muscle, and phosphorylation of insulin receptor substrate 1 at serine 307 (pIRS‐1 Ser307) was significantly lower (p ˂ 0.05) in hepatic tissue of +Cr group. After parturition, pIRS‐1 Ser307 was significantly lower in muscle tissue at days 7 and 28 (p ˂ 0.05 and p ˂ 0.001, respectively), while phosphorylation of Akt at serine 473 (pAkt Ser473) was significantly higher (p ˂ 0.01) in hepatic tissue at day 7 AP in +Cr group. Chromium had opposite effect on insulin kinetics during IVGTTs obtained BP and AP. Insulin secretion was significantly reduced at day 7 BP and significantly enhanced at day 10 AP, when NEFA concentration was also significantly increased. Milk yield and ECM value were depressed in +Cr group. DMI and BCS were significantly enhanced in +Cr group at day 7 BP. In conclusion, chromium modulates insulin signalling pathway in dairy cows, but targeted signalling molecules are different in antepartal then post‐partal period, probably due to duration of exposure to chromium and different energy status between those periods.
In the treatment of degenerative lumbar stenosis, facet-sparing laminectomy with instrumented fusion (FSL) was recently almost totally replaced by less invasive, allegedly equally effective surgical ...techniques. We performed a long-term comparison between outcomes after Young laminoplasty (YL) as a representative of the less invasive technique and FSL.
From December 4, 2000, to March 11, 2005, 56 patients with a history of neurogenic claudication and radiologically verified absolute lumbar stenosis were surgically treated. After applying inclusion and exclusion criteria, 44 patients were enrolled.
Using the Oswestry Disability Index scale, significant improvement on 1-year and 8-year follow-up examinations was noticed in the FSL and YL groups. The Oswestry Disability Index was significantly better in the FSL group compared with the YL group at the 8-year follow-up (27.82 ± 1.918 vs. 40.74 ± 2.163).
FSL is a more invasive and more expensive surgical technique than YL. In a short-term and long-term follow-up comparison, FSL is a more successful operative technique, and the difference increases over time in favor of FSL.
This pilot study aimed to identify quantitative electroencephalographic (qEEG) biomarkers for children and adolescents with attention deficit hyperactivity disorder (ADHD). We examined whether qEEG ...power correlates with the behavioral symptoms. We included 89 children with ADHD and 77 healthy children as a control group. We conducted EEG spectral analysis in the eyes-closed and eyes-opened conditions and compared the findings with a normative database (Human Brain Index). We measured behavioral parameters by using scales proposed by Barkley. The findings revealed an age-dependent decrease in qEEG power in children with ADHD. We found significant discrimination between children with ADHD and healthy children in the theta/beta ratio and theta activity in the frontal area. We found a notable increasing trend in beta activity across two age groups (6-10 years and > 10 years). Correlation analysis showed an association between qEEG power and hyperactivity in younger children with ADHD, while theta activity in the frontal region correlated positively with hyperactivity. The qEEG power of children with ADHD decreased gradually as age increased, and these changes were related to their symptoms. This pilot study suggests that qEEG differences between children with ADHD and healthy children may serve as a sensitive diagnostic tool, depending on the child's age. Further research building upon these findings could deepen our understanding of ADHD and its neural correlates.
Many non-pharmacological treatments for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) have been attempted, but reports indicate that most are ineffective. Although ...neurofeedback (NF) is a treatment approach for children with ADHD that remains promising, a variety of appropriate measures have been used in reporting and evaluating its effect.
To report the self-evaluations of NF treatment by children and adolescents with ADHD.
Randomized controlled trial in 91 children and adolescents with ADHD, aged less than 18 years (mean, 11.2 years) participated in a 30-session program of intensive NF treatment. Participants were randomized and allocated by sequentially numbered sealed envelopes into three groups: methylphenidate (MPH) as an active control group, and two trial groups NF with MPH, and NF alone. ADHD core symptoms and school performance were given on a scale of 1 to 10 using a self-reporting questionnaire, and the changes in these scores after treatment were used as the self-reported evaluation. Basic statistical methods (descriptive, analyses of variance, exact χ (2) test, and paired t-test) were used to investigate the baseline data. Changes in ADHD core symptoms and treatment effects were investigated using a general linear model for repeated measures.
Eighty participants completed the treatment study and 73 (91%) responded sufficiently on the self-reporting questionnaires. The treatment groups were comparable in age, sex, and cognition as well as in the baseline levels of core ADHD symptoms. All treatments resulted in significant improvements regarding attention and hyperactivity (P<0.001), and did not differ from each other in effectiveness. However, a significant treatment effect in school performance was observed (P=0.042), in which only the NF group showed a significant improvement.
The self-reported improvements in ADHD core symptoms and school performance shortly after treatment indicate NF treatment being promising in comparison with medication, suggesting NF as an alternative treatment for children and adolescents who do not respond to MPH, or who suffer side effects. Further long-term follow-up is needed.
Background: Different treatment approaches aimed at reducing attention-deficit/hyperactivity disorder (ADHD) core symptoms are available. However, factors such as intolerance, side-effects, lack of ...efficacy, high new technology costs, and placebo effect have spurred on an increasing interest in alternative or complementary treatment.
Aim: The aim of this study is to explore efficacy of multimodal treatment consisting of standard stimulant medication (methylphenidate) and neurofeedback (NF) in combination, and to compare it with the single treatment in 6-month follow-up in ADHD children and adolescents.
Methods: This randomized controlled trial with 6-month follow-up comprised three treatment arms: multimodal treatment (NF + MED), MED alone, and NF alone. A total of 130 ADHD children/adolescents participated, and 62% completed the study. ADHD core symptoms were recorded pre-/post-treatment, using parents' and teachers' forms taken from Barkley's Defiant Children: A Clinician's Manual for Assessment and Parent Training, and a self-report questionnaire.
Results: Significant ADHD core symptom improvements were reported 6 months after treatment completion by parents, teachers, and participants in all three groups, with marked improvement in inattention in all groups. However, no significant improvements in hyperactivity or academic performance were reported by teachers or self-reported by children/adolescents, respectively, in the three groups. Changes obtained with multimodal treatment at 6-month follow-up were comparable to those with single medication treatment, as reported by all participants.
Conclusions: Multimodal treatment using combined stimulant medication and NF showed 6-month efficacy in ADHD treatment. More research is needed to explore whether multimodal treatment is suitable for ADHD children and adolescents who showed a poor response to single medication treatment, and for those who want to reduce the use of stimulant medication.
Graphical depiction of LUMOs of cis and trans isomers of VO(acac)2pyr complexes in oxidized state, and corresponding SOMOs of the reduced state.
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The use of vanadium complexes for ...potential applications in medicine largely depends on the structural properties of the complex itself, as well as on the electronic configuration of the metal and its oxidation state. When the vanadium complex binds to biomolecules or by binding solvent molecules to the complex, there is a change in the structure but also a change in the redox properties of the complex. Using theoretical methods, especially Density Functional theory (DFT), it is possible to determine which factors influence changes in the redox properties of the complex. Furthermore, by calculating the Electron Paramagnetic Resonance (EPR) constants of hyperfine coupling, it is possible to obtain not only data on the electronic configuration, but also to predict changes in redox properties upon changes in the structure of the complex. DFT results show that the binding of pyridine or imidazole to the VO(acac)2 complex leads to a lowering of the redox potential. The largest changes in the redox potential were observed in the case when the incoming ligand binds in a cis position relative to the VO bond.
Abstract This study describes the characteristics of children suffering from attention deficit/hyperactivity disorder (ADHD) symptoms and evaluates the ability of primary health care to assess ADHD. ...A population of 494 children was referred during one year to the outpatient clinic Child and Adolescent Mental Health in Norway. Forty percent of those referred had ADHD symptoms. A clinical assessment regarding ADHD as well as general health was employed and socio-economic status was recorded. Half of the ADHD-referred children met criteria for ADHD, and among the non-ADHD children one fifth did not receive any diagnosis. Mean referral age was 10.5 years; 82% were boys. The ADHD families were less educated and in more need of support from Child Welfare (CW) in the referral period (OR: 3.9; 95% CI 0.1 to 5.1). More ADHD children were not living with their families compared to the non-ADHD children. The sensitivity was 51% (96/187) regarding primary health care`s ability to recognize ADHD. Further screening programs for evaluation of ADHD are needed.
Peripheral arterial disease (PAD) is common in patients with end-stage renal disease on hemodialysis, but is frequently underdiagnosed. The risk factors for PAD are well known within the general ...population, but they differ somewhat in hemodialysis patients. This study aimed to determine the prevalence of PAD and its risk factors in patients on hemodialysis.
This cross-sectional study included 156 hemodialysis patients. Comorbidities and laboratory parameters were analyzed. Following clinical examinations, the ankle-brachial index was measured in all patients. PAD was diagnosed based on the clinical findings, ankle-brachial index < 0.9, and PAD symptoms.
PAD was present in 55 of 156 (35.3%; 95% CI, 27.7-42.8%) patients. The patients with PAD were significantly older (67 ± 10 years vs. 62 ± 11 years, p = 0.014), more likely to have diabetes mellitus (p = 0.022), and anemia (p = 0.042), and had significantly lower serum albumin (p = 0.005), total cholesterol (p = 0.024), and iron (p = 0.004) levels, higher glucose (p = 0.002) and C-reactive protein (p < 0.001) levels, and lower dialysis adequacies (p = 0.040) than the patients without PAD. Multivariate analysis showed higher C-reactive protein level (odds ratio OR, 1.03; 95% confidence interval CI, 1.00-1.06; p = 0.030), vascular access by Hickman catheter (OR, 4.66; 95% CI, 1.03-21.0; p = 0.045), and symptoms of PAD (OR, 5.20; 95% CI, 2.60-10.4; p < 0.001) as independent factors associated with PAD in hemodialysis patients.
The prevalence of PAD was high among patients with end-stage renal disease on hemodialysis. Symptoms of PAD, higher C-reactive protein levels, and Hickman vascular access were independent predictors of PAD in patients on hemodialysis.
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