This document discusses attention and working memory in pediatric epilepsy. It provides a brief history of ADHD and reviews the diagnostic criteria. Attention problems are common in epilepsy and may account for academic underachievement. While rates of ADHD in epilepsy vary, studies find prevalence is higher than the general population. Methylphenidate may be safely used to treat comorbid ADHD and epilepsy. Executive dysfunction, including problems with working memory, are seen in many children with epilepsy and can impact academic performance.
Effects of Hyperbaric Oxygen Therapy on Brain Perfusion, Cognition and Behavi...BARRY STANLEY 2 fasd
Abstract
A 15-year-old girl diagnosed with FASD underwent 100 courses of hyperbasic oxygen therapy (HBOT). Prior to HBOT, single motion emission compute tomographic begin imaging (SPECT)
revealed areas of hypo-perfusion bilaterally in the orbitofrontal region, temporal lobes and right dorsolateral—frontal, as well the medial aspect of the left cerebellum. Following two sets of HBOT treatments (60 plus 40), over 6 months, there was improvement in perfusion to the left cerebellum as well as the right frontal lobe. This was paralleled by improvement in immediate cognitive tests and an increase in functional brain volume. A follow-up 18 months after HBOT showed sustained
improvement in attention with no need for methylphenidate, as well as in math skills and writing.
This is a paper I wrote for school on brain impairments in attention deficit hyperactivity disorder, with a focus on neuroanatomical differences and connectivity patterns. I reviewed findings from various studies, considered their limitations, and proposed directions for future research.
Effects of Hyperbaric Oxygen Therapy on Brain Perfusion, Cognition and Behavi...BARRY STANLEY 2 fasd
Abstract
A 15-year-old girl diagnosed with FASD underwent 100 courses of hyperbasic oxygen therapy (HBOT). Prior to HBOT, single motion emission compute tomographic begin imaging (SPECT)
revealed areas of hypo-perfusion bilaterally in the orbitofrontal region, temporal lobes and right dorsolateral—frontal, as well the medial aspect of the left cerebellum. Following two sets of HBOT treatments (60 plus 40), over 6 months, there was improvement in perfusion to the left cerebellum as well as the right frontal lobe. This was paralleled by improvement in immediate cognitive tests and an increase in functional brain volume. A follow-up 18 months after HBOT showed sustained
improvement in attention with no need for methylphenidate, as well as in math skills and writing.
This is a paper I wrote for school on brain impairments in attention deficit hyperactivity disorder, with a focus on neuroanatomical differences and connectivity patterns. I reviewed findings from various studies, considered their limitations, and proposed directions for future research.
Over the past few decades, the prognosis of neonatal seizures has experienced considerable enhancement due to the improvement in neonatal and infant care. The mortality rate of neonatal seizures has fallen from 40% to 20%, and the relationship between electro encephalogram (EEG) and prognosis has become quite clear. The underlying cause of seizures is a major determinant of the outcome of the disease. For example, patients with secondary seizures and hypoxic-ischemic encephalopathy have only 50% chance of normal development and total recovery, while newborns with secondary seizures and subarachnoid hemorrhage or better hypocalcemia have higher chances of recovery. Searches were conducted by two independent researchers in international (PubMed, Web of Science, Scopus, and Google Scholar) and national (SID and Magiran) databases for related studies from the inception of the databases to September 2017 (without time limitation) in English and Persian languages. It is possible to achieve accurate diagnosis through checking the history before birth and performing a thorough physical examination in some rare cases. Depending on the case, tests or additional actions can be done. EEG is the primary means for diagnosis and may exhibit paroxysmal activity in the difference between seizures or may produce electrographic seizures in cases where seizure is hidden or latent. One of the most important points in the treatment of neonatal seizures is the diagnosis of underlying cause (such as hypoglycemia, meningitis, drug deprivation, and trauma) because such diagnosis facilitates different approaches to control neonatal seizures. Most experts agree to control all clinical and electrographic seizures. Some others focus merely on clinical seizures. Most centers prefer the first approach. An important point before starting an anticonvulsant drug is to decide if the patient needs intravenous and luteinizing treatment with an initial bolus dose, or it can be easy to start treatment with a prescription for a long-acting medication based on the severity of seizure, duration, and frequency.
KEYNOTE presentation (June 2015), ESCAP Expert Paper (July 2015), TV interview and abstract by professor Beate Herpertz-Dahlmann (Aachen University) on new developments in the diagnostics and treatment of adolescent eating disorders
Brain abnormalities and neurodevelopmental delay in congenital heart disease: systematic review and meta-analysis
A. Khalil, N. Suff, B. Thilaganathan, A. Hurrell, D. Cooper and J.S. Carvalho
Link to free access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.12526/abstract
DESCRIBE THE THREE RECENT NON PHARMACOLOGICAL TECHNIQUES IN ADHD CHILDREN . THESE ARE NEUROFEEDBACK SESSIONS, CRANIAL ELECTROSTIMULATION SESSIONS AND COMPUTERIZED COGNITIVE TRAINING SESSIONS
Presentatie autisme escap 2015m4 madrid how_malleable_is_autism_escap_postUtrecht
KEYNOTE abstract by professor Sally Rogers (UC Davis MIND Institute, Sacramento) titled 'How malleable is autism? Outcome studies from the youngest children with ASD', held at the ESCAP 2015 Congress in Madrid, Monday June 22nd 2015
KEYNOTE presentation by professor Celso Arango (Hospital General Universitario Gregorio Marañón. IiSGM, Universidad Complutense, CIBERSAM. Madrid, Spain) on developmental trajectories in early-onset psychoses, held at the ESCAP 2015 Congress in Madrid, Monday June 22nd 2015
DSM proposal for Sensory Processing Disorder. Of interest to those who want to know more in general, or know more about SPD as it compares to ASD or Misophonia.
REVIEWpublished 24 June 2015doi 10.3389fnhum.2015.003.docxmalbert5
REVIEW
published: 24 June 2015
doi: 10.3389/fnhum.2015.00359
Pathophysiology of ADHD and
associated problems—starting points
for NF interventions?
Björn Albrecht*, Henrik Uebel-von Sandersleben, Holger Gevensleben and
Aribert Rothenberger
Department of Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
Edited by:
Martijn Arns,
Research Institute Brainclinics,
Netherlands
Reviewed by:
Roumen Kirov,
Institute of Neurobiology, Bulgarian
Academy of Sciences, Bulgaria
Leon Kenemans,
Utrecht University, Netherlands
*Correspondence:
Björn Albrecht,
Department of Child and Adolescent
Psychiatry, University Medical Center
Göttingen, von Siebold Straße 5,
37075 Göttingen, Germany
[email protected]
Received: 06 October 2014
Accepted: 02 June 2015
Published: 24 June 2015
Citation:
Albrecht B, Uebel-von Sandersleben
H, Gevensleben H and Rothenberger
A (2015) Pathophysiology of ADHD
and associated problems—starting
points for NF interventions?
Front. Hum. Neurosci. 9:359.
doi: 10.3389/fnhum.2015.00359
Attention deficit hyperactivity disorder (ADHD) is characterized by severe and
age-inappropriate levels of hyperactivity, impulsivity and inattention. ADHD is a
heterogeneous disorder, and the majority of patients show comorbid or associated
problems from other psychiatric disorders. Also, ADHD is associated with cognitive and
motivational problems as well as resting-state abnormalities, associated with impaired
brain activity in distinct neuronal networks. This needs to be considered in a multimodal
treatment, of which neurofeedback (NF) may be a promising component. During NF,
specific brain activity is fed-back using visual or auditory signals, allowing the participants
to gain control over these otherwise unaware neuronal processes. NF may be used
to directly improve underlying neuronal deficits, and/or to establish more general self-
regulatory skills that may be used to compensate behavioral difficulties. The current
manuscript describes pathophysiological characteristics of ADHD, heterogeneity of
ADHD subtypes and gender differences, as well as frequently associated behavioral
problems such as oppositional defiant/conduct or tic disorder. It is discussed how NF
may be helpful as a treatment approach within these contexts.
Keywords: Neurofeedback (NF), ADHD, ODD/CD, tic disorder, comorbidity, children, neurobiology
Introduction
Difficulties with Inattention or Hyperactivity and Impulsivity as the core symptoms of Attention
deficit Hyperactivity disorder (ADHD) are a frequent psychosocial burden. With an early onset
during childhood, ADHD is often persisting throughout life. It is a heterogeneous disorder, and a
challenge to treat. In light of this heterogeneity, the most promising treatment approach should
be multimodal in nature (Taylor et al., 2004; Swanson et al., 2008). Pharmacological interventions
particularly with stimulants such as methylphenidate and amphetamine sulfate, as well as non-
s.
Over the past few decades, the prognosis of neonatal seizures has experienced considerable enhancement due to the improvement in neonatal and infant care. The mortality rate of neonatal seizures has fallen from 40% to 20%, and the relationship between electro encephalogram (EEG) and prognosis has become quite clear. The underlying cause of seizures is a major determinant of the outcome of the disease. For example, patients with secondary seizures and hypoxic-ischemic encephalopathy have only 50% chance of normal development and total recovery, while newborns with secondary seizures and subarachnoid hemorrhage or better hypocalcemia have higher chances of recovery. Searches were conducted by two independent researchers in international (PubMed, Web of Science, Scopus, and Google Scholar) and national (SID and Magiran) databases for related studies from the inception of the databases to September 2017 (without time limitation) in English and Persian languages. It is possible to achieve accurate diagnosis through checking the history before birth and performing a thorough physical examination in some rare cases. Depending on the case, tests or additional actions can be done. EEG is the primary means for diagnosis and may exhibit paroxysmal activity in the difference between seizures or may produce electrographic seizures in cases where seizure is hidden or latent. One of the most important points in the treatment of neonatal seizures is the diagnosis of underlying cause (such as hypoglycemia, meningitis, drug deprivation, and trauma) because such diagnosis facilitates different approaches to control neonatal seizures. Most experts agree to control all clinical and electrographic seizures. Some others focus merely on clinical seizures. Most centers prefer the first approach. An important point before starting an anticonvulsant drug is to decide if the patient needs intravenous and luteinizing treatment with an initial bolus dose, or it can be easy to start treatment with a prescription for a long-acting medication based on the severity of seizure, duration, and frequency.
KEYNOTE presentation (June 2015), ESCAP Expert Paper (July 2015), TV interview and abstract by professor Beate Herpertz-Dahlmann (Aachen University) on new developments in the diagnostics and treatment of adolescent eating disorders
Brain abnormalities and neurodevelopmental delay in congenital heart disease: systematic review and meta-analysis
A. Khalil, N. Suff, B. Thilaganathan, A. Hurrell, D. Cooper and J.S. Carvalho
Link to free access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.12526/abstract
DESCRIBE THE THREE RECENT NON PHARMACOLOGICAL TECHNIQUES IN ADHD CHILDREN . THESE ARE NEUROFEEDBACK SESSIONS, CRANIAL ELECTROSTIMULATION SESSIONS AND COMPUTERIZED COGNITIVE TRAINING SESSIONS
Presentatie autisme escap 2015m4 madrid how_malleable_is_autism_escap_postUtrecht
KEYNOTE abstract by professor Sally Rogers (UC Davis MIND Institute, Sacramento) titled 'How malleable is autism? Outcome studies from the youngest children with ASD', held at the ESCAP 2015 Congress in Madrid, Monday June 22nd 2015
KEYNOTE presentation by professor Celso Arango (Hospital General Universitario Gregorio Marañón. IiSGM, Universidad Complutense, CIBERSAM. Madrid, Spain) on developmental trajectories in early-onset psychoses, held at the ESCAP 2015 Congress in Madrid, Monday June 22nd 2015
DSM proposal for Sensory Processing Disorder. Of interest to those who want to know more in general, or know more about SPD as it compares to ASD or Misophonia.
REVIEWpublished 24 June 2015doi 10.3389fnhum.2015.003.docxmalbert5
REVIEW
published: 24 June 2015
doi: 10.3389/fnhum.2015.00359
Pathophysiology of ADHD and
associated problems—starting points
for NF interventions?
Björn Albrecht*, Henrik Uebel-von Sandersleben, Holger Gevensleben and
Aribert Rothenberger
Department of Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
Edited by:
Martijn Arns,
Research Institute Brainclinics,
Netherlands
Reviewed by:
Roumen Kirov,
Institute of Neurobiology, Bulgarian
Academy of Sciences, Bulgaria
Leon Kenemans,
Utrecht University, Netherlands
*Correspondence:
Björn Albrecht,
Department of Child and Adolescent
Psychiatry, University Medical Center
Göttingen, von Siebold Straße 5,
37075 Göttingen, Germany
[email protected]
Received: 06 October 2014
Accepted: 02 June 2015
Published: 24 June 2015
Citation:
Albrecht B, Uebel-von Sandersleben
H, Gevensleben H and Rothenberger
A (2015) Pathophysiology of ADHD
and associated problems—starting
points for NF interventions?
Front. Hum. Neurosci. 9:359.
doi: 10.3389/fnhum.2015.00359
Attention deficit hyperactivity disorder (ADHD) is characterized by severe and
age-inappropriate levels of hyperactivity, impulsivity and inattention. ADHD is a
heterogeneous disorder, and the majority of patients show comorbid or associated
problems from other psychiatric disorders. Also, ADHD is associated with cognitive and
motivational problems as well as resting-state abnormalities, associated with impaired
brain activity in distinct neuronal networks. This needs to be considered in a multimodal
treatment, of which neurofeedback (NF) may be a promising component. During NF,
specific brain activity is fed-back using visual or auditory signals, allowing the participants
to gain control over these otherwise unaware neuronal processes. NF may be used
to directly improve underlying neuronal deficits, and/or to establish more general self-
regulatory skills that may be used to compensate behavioral difficulties. The current
manuscript describes pathophysiological characteristics of ADHD, heterogeneity of
ADHD subtypes and gender differences, as well as frequently associated behavioral
problems such as oppositional defiant/conduct or tic disorder. It is discussed how NF
may be helpful as a treatment approach within these contexts.
Keywords: Neurofeedback (NF), ADHD, ODD/CD, tic disorder, comorbidity, children, neurobiology
Introduction
Difficulties with Inattention or Hyperactivity and Impulsivity as the core symptoms of Attention
deficit Hyperactivity disorder (ADHD) are a frequent psychosocial burden. With an early onset
during childhood, ADHD is often persisting throughout life. It is a heterogeneous disorder, and a
challenge to treat. In light of this heterogeneity, the most promising treatment approach should
be multimodal in nature (Taylor et al., 2004; Swanson et al., 2008). Pharmacological interventions
particularly with stimulants such as methylphenidate and amphetamine sulfate, as well as non-
s.
Prof. Dr. Vladimir Trajkovski - Health issues and health care in ASD Vladimir Trajkovski
Prof. Dr. Vladimir Trajkovski presented topic: Health issues and health care in persons with autism spectrum disorders at international autism conference held in Krakow September 27th, 2018.
Attention deficit hyperactivity disorder is a lifelong neurodevelopmental disorder that affects the brain and results in a variety of inappropriate and maladaptive behaviors. ADHD is not a disease (Kajander 1995) but is a processing deficit that results in children having difficulty with inhibitory control. That is, children with ADHD lack self-control, something they cannot help. In children with ADHD, the parts of the brain that control attention and stop inappropriate behavior are underdeveloped (Barkley 1996; Kajander 1995). ADHD occurs three times more frequently in male students than female students (Reeve et al. 1995) and commonly occurs with other disorders. For example, ADHD occurs in 20 percent to 50 percent of the students with learning disabilities, in 65 percent of the students with oppositional defiant disorder, and in 20 percent to 30 percent of the students with conduct disorder (Reeve et al. 1995; Barkley 1990).
Genetics of attention deficit hyperactivity disorder (adhd)Joy Maria Mitchell
Attention deficit hyperactivity disorder (ADHD) is a developmental disorder. ADHD is the commonly studied and
diagnosed as psychiatric disorder. Here we shall see the relation between extraversion and ADHD, neuroticism,
biological relation, Environmental factors and with diagnosis of ADHD. It is known that Genetics is one of the factors
that may contribute to, or exacerbate ADHD. Recent research probing towards the environmental and Genetic factors
causing ADHD differences is the main source for investigation
ADHD is becoming much prevalent in childhood and adolescent , comorbidities like learning disability, anxiety, depression, autism spectrum disorder and tourette syndrome . Regarding the treatment we have to put in mind the comorbid disorder . Amphetamine Methylphenidate, Atomoxetine and behavioral treatment are considered of value in treating ADHD and comorbidities , ,
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
1. Pay Attention to This: Attention and Working Memory in Pediatric Epilepsy William S. MacAllister, Ph.D. Pediatric Neuropsychologist
2. To be discussed… Brief History of ADHD Review of the Diagnostic Criteria Associated Features / Comorbid Conditions Attention Problems in Epilepsy Treatment Considerations
3. History First descriptions of ADHD may have appeared 2500 years ago Hippocrates described a patient who had quickened responses to sensory experiences, but also less tenaciousness because the soul moves on quickly to the next impression Condition was attributed to an overbalance of fire over water
4. History Continued… George Frederick Still (1902) Defined chief characteristics in 43 kids “defects in moral control” “abnormal incapacity for sustained attention, restlessness, fidgetiness, violent outbursts, destructiveness, non-compliance” Demonstrate little “inhibitory volition”
5. Encephalitis outbreak of 1917 Called attention to the fact that these children showed similar deficits and allowed scientists of the day to draw parallels between these groups Gave rise to the concept of “minimal brain dysfunction”
9. ADHD is one of the most common psychiatric conditions of childhood Considered one of the best-researched disorders in medicine and the overall data on its validity are far more compelling than for many medical conditions (Goldman et al, 1998) In clinic samples, boys are 6-10x more likely to be referred for the d/o and 3-4x more likely to be dx May reflect biases - girls less likely to be disruptive
10. Several recent epidemiological studies of ADHD have been conducted Rowland et al, 2002; Harel & Brown, 2002; Barbaresi et al, 2002; CDC, 2005 Prevalence across these studies fairly consistent, with estimates between 6 and 10% Estimated to affect 4.4 million children in U.S. Interestingly, many identified a “treatment gap”
11. CDC Study For example, the CDC study indicated that 7.8% of children met criteria at some point in their lifetime But only 4.3% were treated with medications (only 55% of those with ADHD were treated pharmacologically)
12. In kids… Higher rates of ER admissions (Leibson et al 2001) More burns, TBI, fractures Driving accidents more common in adolescence More driving offenses (speeding, reckless driving -> suspended licenses) Higher rates of STD’s (4x higher; Fischer, 93) Higher teen pregnancy rates
14. Learning Disabilities LD’s are comorbid in over 20% of cases Reading disorders (16-39%) Spelling problems (24-27%) Math disorders (13-33%)
15. DCD Approximately 6% of population with higher rates in ADHD Clumsiness, dysgraphia, articulation deficits Likely due to underlying neural substrates involving cortical-basal ganglia circuitry (see Delong 2002)
16. Milich et al, 2002; Coghill et al 2005 believe that ADHD-C and ADHD-I are actually “distinct disorders”
17.
18.
19. Cognition in Epilepsy Well established that inattention and hyperactivity are behavioral symptoms common in childhood onset epilepsy (Dunn & Austin, 1999) Such symptoms may, in large part, account for the degree of academic underachievement in these children
20. Prevalence of ADHD in epilepsy varies widely across samples studied and measures employed Epidemiological studies Rutter et al. (1970): Hyperactivity seen in 4/34 children with epilepsy (Isle of Wight Study: UK) McDermott et al (1995): Hyperactivity seen is 28% of children with epilepsy, versus 13% in cardiac patients, and 5% in control children Carlton-Ford et al (1995): Impulsivity seen in 39% of children with current OR past seizures, versus 11% in controls
21. Teacher Report Holdsworth and Whitmore (1974) – Teachers report inattention in 42% of children with seizures Sturniolo and Galletti (1994): Inattention or hyperactivity in 58% of children with seizures No standardized measures or diagnostic procedures
22. Dunn et al 2003 study Studied relations of ADHD Symptoms and: Seizure type Localization Study examined 175 children (85 boys, 90 girls) Mean age = 11y 10m Recruited from private practices and University Hospital samples
23. Measures CBCL (Achenbach) Dimensional instrument of symptoms CSI-4 / ASI-4 (Gadow and Sprafkin) Categorical and Dimensional Based on DSM-4 criteria
25. CBCL Results 42% of Adolescents and 58% of children were in the “at-risk” range for attention problems 25% adolescents and 37% of children were in the “clinical” range
29. Interesting findings of this study: In contrast to ADHD in non-epilepsy patients: Inattentive subtype ADHD was more common than Combined Girls were more likely to have ADHD than boys
30. Hermann et al (2007) Studied 75 children and adolescents with new onset epilepsy (ages 8 – 18) and 62 Controls KSADS Interview, Neuropsych ADHD was present in 31% of patients and only 6% of controls Inattentive subtype predominated, with symptoms of ADHD appearing before seizures Children with ADHD and epilepsy had higher rates of school interventions/services Neuropsych evaluation revealed prominent executive dysfunction ADHD was not associated with epilepsy characteristics or demographic variables
31. Executive Dysfunction Slick et al 2006 BRIEF as primary measure 80 children and adolescents with intractable epilepsy
33. Treatment (Pharmacological) Methylphenidate (e.g., Ritalin; MPH) is commonly believed to lower seizure threshold PDR suggests that methylephenidate is contraindicated in children with epilepsy However, no controlled studies have proved this hypothesis Only isolated case studies seem to support MPH as analeptic
34. Safety Several publications indicate that MPH is safe in children with controlled epilepsy (Feldman et al, 1989) – 10 children with ADHD and Epilepsy – MPH effectively treated ADHD Symptoms and no seizures were seen during the 10 weeks of follow-up. All had abnormal EEG’s that were unchanged during the study
35. Gross-Tsur et al (1997) 30 Children with epilepsy and ADHD (25 were seizure free on AED’s, 5 with occasional seizures) Those that were seizure free prior to MPH remained so after MPH Those with ongoing seizures did not show an increase in seizure frequency
36. Gucuyener et al (2003) Followed two groups for one year one with ADHD and epilepsy, one with ADHD and EEG abnormalities (but no clinical seizures) MPH improved ADHD symptoms in both groups The epilepsy group experienced no change in seizure frequency AND EEG’s improved No patients in the abnormal EEG group experienced seizures
37. Summary of MPH studies Most agree that MPH is not contraindicated in children with ADHD No compelling evidence that MPH will increase risk of seizures in children with ADHD will cause seizures in those with ADHD and abnormal EEG or will increase seizure frequency in children with ADHD and epilepsy
38. Treatment with Amphetamines (e.g., Adderall, Dexedrine, Vyvanse) Effects of these agents in children with ADHD and Epilepsy has NOT been systematically studied Torres et al (2008) in their review of the evidence noted that: “Amphetamines might be proconvulsant, especially when abused; however there is some evidence that amphetamines may have an anticonvulsant effect in select patients.” “Case series for ADHD plus Epilepsy have reported disappointing response rates to amphetamine”
39. Atomoxetine (Strattera) No well-controlled trials of Atomoxetine in patients with ADHD and epilepsy Summarizing the results of available data “the rate of the positive response to atomoxetine was disappointing” (Torres et al, 2008) However, it was noted that almost all of the patients placed on Strattera had already had unsuccessful trials of stimulants
40. Summary of Medication studies suggest that MPH may be the best supported treatment in children with epilepsy and comorbid ADHD
41. Summary Points Rate of ADHD in children with epilepsy is several times higher than in general population (5 times higher?) Inattentive subtype more common Girls more affected than boys May be primary reason for school underachievement All seizure types at risk MPH may be treatment of choice
42. What is an Executive Function? Key elements: Anticipation and deployment of attention Impulse control/self-regulatory processes Initiation Working memory Mental flexibility Planning/organization Problem solving
43. What does executive dysfunction look like? Inability to focus or maintain attention Impulse control deficits Poor working memory Difficulties self-monitoring Inability to plan Disorganization Poor reasoning Perseveration
44. Neuroanatomy PFC (particularly dorsolateral PFC) are the last brain regions to myelinate PFC play a critical role in executive fx Region does not act in isolation Part of broader functional system Highly interconnected with other regions Damage to PFC is sufficient, but not necessary for executive dysfunction e.g., subcortical structures (basal ganglia) as well as the cerebellum are also crucial
45. Yeah… but what is workingmemory? Working Memory: A limited capacity memory system that provides temporary storage to manipulate complex cognitive tasks…
46. BaddeleyModel of Working Baddeley Model deals mainly with working memory Working memory – “a limited capacity system allowing the temporary storage and manipulation of information necessary for such complex tasks as comprehension, learning, and reasoning” (Baddeley, 2000) Holding information ‘On-line’ while operating on it.
47. Why is working memory important? Working memory deficits have the potential to adversely affect children in academic pursuits
48. School Note taking in class requires a tremendous amount of working memory Children must dual task as they listen to what the teacher is saying, while concurrently writing down what they have just said i.e., the ‘lag’ between the teacher’s real time speech and the child’s handwriting necessitates working memory for them to keep up with the demands of the classroom
49. Academic Achievement Several studies have linked executive function deficits (and particularly working memory deficits) to objective performance on academic tasks, even in children who do nothave primary learning disabilities…