170 research outputs found
Acute Dependency Reaction to Meperidine: A case report
No full textPostoperative discitis is a rare and painful complication that may emerge following spine procedures. We present a 34-year-old male patient with postoperative discitis who had been addicted to meperidine during pain relief. Three weeks after routine lumbar discectomy, this patient presented with clinical findings and radiographic imaging consistent with discitis. Meperidine, rate of administration was 1 mg/kg three times a day, was prescribed for his low back pain. After two weeks of opioid therapy an iatrogenic meperidine addiction occurred. Opioid analgesics are helpful for excessive painful conditions as a discitis. Although this case showed us we should be careful when we prescribe opioids
On Unfair Permutations
No full textIslak, Umit/0000-0003-4281-5171In this paper we study the inverse of so-called unfair permutations. Our investigation begins with comparing this class of permutations with uniformly random permutations, and showing that they behave very much alike in case of locally dependent random variables. As an example of a globally dependent statistic we use the number of inversions, and show that this statistic satisfies a central limit theorem after proper centering and scaling. (C) 2018 Elsevier B.V. All rights reserved.TUBITAK [113F059]; Scientific and Research Council of Turkey [TUBITAK-117C047]The author C. P. has been supported by TUBITAK within the project 113F059 entitled "The conjecture of Mazur-Tate-Teitelbaum, CM elliptic curves and applications" as a postdoctoral researcher at Koc University. The author U.I. is supported by the Scientific and Research Council of Turkey [TUBITAK-117C047]. Parts of this paper were completed at the Nesin Mathematics Village, the authors would like to thank Nesin Mathematics Village for their kind hospitality. Also, the authors would like to thank an anonymous referee who detected some errors in original manuscript, and whose comments improved the paper significantly
Neurotrophic factors and hippocampal activity in PTSD
No full textAlthough numerous studies have investigated the neurotrophic factors and hippocampal activity in posttraumatic stress disorder (PTSD) separately each other, it is unclear whether an association between neurotrophic factors and hippocampal activity is present. The aim of this study was to evaluate the functional changes in hippocampus before and after treatment with escitalopram and to associate these changes with peptides related to neuronal growth in patients with chronic PTSD and trauma survivors without PTSD. Fifteen earthquake survivors with chronic PTSD and thirteen drug nave trauma exposed individuals without PTSD underwent fMRI scans in a block design. Serum levels of Nerve Growth Factor (NGF) and Brain Derived Neurotrophic Factor (BDNF) were measured before and after 12 weeks treatment with escitalopram. Baseline median serum level of NGF was significantly lower in patients with chronic PTSD than trauma survivors; however, 12 weeks of treatment with escitalopram significantly increased it. Higher activation was found both in left and right hippocampus for chronic PTSD group than trauma survivors. Treatment with escitalopram was significantly associated with suppression of the hyperactivation in left hippocampus in patients with chronic PTSD. Bilateral hyperactivation in hippocampus and lowered NGF may associate with neurobiological disarrangements in chronic PTSD. Treatment with escitalopram was significantly associated with both improvement in the severity of PTSD symptoms and biological alterations. Patients diagnosed with PTSD may have further and complicated deteriorations in hippocampal networks and neurotransmitter systems than individuals who had not been diagnosed with PTSD following the same traumatic experience
DOUBLE BLIND CONTROLLED STUDY OF ADDING FOLIC ACID TO FLUOXETINE IN THE TREATMENT OF OCD
No full textBackground: Folate is important for the synthesis of serotonin the neurotransmitter which plays a main role in OCD. We, therefore, explored the efficacy of folic acid as add on treatment to fluoxetine in a double blind study among patients with OCD. Subjects and methods: A double blind, 12-week study comparing the efficacy of folic acid as add on treatment and placebo in patients with OCD was conducted on thirty six (36) patients. Patients were randomly assigned to folic acid (5 mg/day) or placebo group in addition to fluoxetine (40 mg/day). After the baseline assessment, on week 2, 4, 6, 8 and 12 assessments were performed by using YBOCS, HAM-D, HAM-A and CGI-S. Serum folate, erythrocyte folate, serum homocysteine and B-12 levels were measured both baseline and the end of study. Results: A mixed model repeated measures ANCOVA on Y-BOCS scores were used to determine the difference between folic acid and placebo groups. No significant differences were found in the ratios of gender or in the mean age, serum folic acid level, erythrocyte folate level, serum homocysteine level and serum B-12 level between the treatment groups at the baseline. Consecutively scores collected over six measurements on YBOCS, HAM-D, HAM-A and CGI showed non-significant differences between folic acid and placebo groups. Conclusion: None of the biological markers of one carbon metabolism were associated with the change in YBOCS scores. It may be assumed that there is no beneficial effect of folic acid addition to fluoxetine in the treatment of OCD
Proton magnetic resonance spectroscopic analysis of changes in brain metabolites following electroconvulsive therapy in patients with major depressive disorder
No full textObjectives: The aim of this study was to evaluate the metabolic changes in the anterior cingulate cortex (ACC) induced by electroconvulsive therapy (ECT) in patients with MDD via H-1-MRS. Methods: The study was conducted on 13 MDD patients receiving ECT treatment and 14 healthy controls matched in terms of age, gender and education. The patients underwent six sessions of ECT. H-1-MRS imaging and psychometric evaluations obtained before 1st and after the 6th sessions. The control group also went through the same procedures except for ECT. N-Acetyl aspartate (NAA), choline (Cho) and creatine (Cr) metabolite levels and the creatine to metabolite ratios were measured. Results: There was no significant difference in the ACC metabolite levels of the patients and those of the controls at the baseline. ECT associated with a statistically significant decrease in the NAA/Cr ratio in ACC. All of the patients had responded to ECT treatment as measured with the clinical scales. Conclusions: The results has suggested that indirect proof of an increase in energy metabolism without any evidence of impaired neuronal viability in the ACC induced by ECT. The relative increase in Cr levels following ECT in MDD seems to be associated with improvement in clinical severity
Low-cost, highly efficient, and tunable ultrafast laser technology based on directly diode-pumped Cr:Colquiriites
No full textThesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2010.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Cataloged from student submitted PDF version of thesis.Includes bibliographical references (p. 335-352).This doctoral project aims to develop robust, ultra low-cost (150) as the pump source, we have obtained continuous-wave (cw) output powers >250-mW with slope efficiencies >50%. Record cw tuning ranges were demonstrated for Cr:LiSAF (775-1042 nm), Cr:LiSGaF (777-977 nm), and Cr:LiCAF (754-871 nm). For femtosecond pulse generation, semiconductor saturable absorber mirrors (SESAMs/SBRs) were developed, which were used to initiate and sustain mode-locking. Typical performance was ~25-100 fs pulses, with an optical spectrum in the 770-920 nm range, with ~1-2 nJ of pulse energies from ~100-MHz repetition rate cavities. Record electrical-to-optical conversion efficiencies of ~10% were demonstrated in the cw mode-locked regime. A mode-locked tuning range of 767-817 nm, with ~130-fs long pulses was obtained by using Cr:LiCAF as gain medium. With the Cr:LiSAF gain medium, using regular SESAMs/SBRs centered around 800 nm, 850 nm, and 910 nm, mode-locked tuning ranges of 803-831 nm, 828-873 nm, and 890-923 nm were demonstrated, respectively. By using a broadband oxidized SESAM/SBR, a record tuning range of 800-905 nm was demonstrated with ~150-fs long pulses. Using an extended cavity Cr:LiCAF laser, pulse energies >15-nJ with peak powers exceeding 100-kW were obtained. We performed the first cavity-dumping experiments with a Cr:Colquiriite laser and demonstrated pulse energies >100-nJ, and peak powers approaching MW level, at repetition rates up to 50-kHz. Cr:LiCAF gain media were also pumped by single-emitter multimode diodes, where we obtained >2-W output power in cw operation, and ~100-fs pulses with 390-mW of average power at a repetition rate of 140 MHz in cw mode-locked operation. As an example application area for this low cost technology, we performed multiphoton microcopy experiments with a single-mode diode-pumped Cr:LiCAF laser. We also performed attosecond-resolution timing jitter characterization experiments of the femtosecond Cr:LiSAF laser, and measured a record-low upper limit for the integrated timing jitter of the Cr:LiSAF laser (137-attoseconds in 10 kHz-10 MHz range).by Umit Demirbas.Ph.D
The Importance of Conduct Disorder in the Treatment of Violence in Schizophrenia: Efficacy of Clozapine Compared With Olanzapine and Haloperidol
No full textPanic disorder subtypes: Further clinical differences
No full textPanic disorder (PD) is a heterogeneous phenomenon with respect to symptom profile. Most studies agree that a group of patients with prominent respiratory symptoms emerged as a distinct PD subtype. In this study we compared a range of clinical features associated with PD and agoraphobia in patients with respiratory (RS) and nonrespiratory (NRS) subtypes of PD. The participants were 124 patients with PD (79 women and 45 men), with or without agoraphobia, diagnosed by DSM-IV criteria. Following the observer-rated Panic Disorder Severity Scale assessment, subjects completed self-report measures, including the Anxiety Sensitivity Index (ASI), Panic-Agoraphobia Scale; the Beck Anxiety Inventory; and the Panic-Agoraphobic Spectrum Scale (PAS-SR). Multivariate analysis of variance (MANOVA) showed significant group differences [Pillai's trace= 0.95, F(5, 118)(=)2.48, P=.036]. Patients in RS group had higher mean total scores on the ASI (F= 5.00, df= 1, P=.027) and PAS-SR (F = 11.23, df= 1, P =. 001) than patients in NRS group. Also, patients with RS attained higher scores than patients with NRS on four domains of PAS-SR (panic-like symptoms, agoraphobia, separation sensitivity, and reassurance seeking). A descriptive discriminant analysis of the data correctly identified 69.4% of the patient group in general and 86.1% of RS group (Wilks's lambda = 0.87, df = 8, P =. 048). The significant discriminating factors of the RS and NRS groups were domains of panic-like symptoms, agoraphobia, separation sensitivity, and reassurance seeking. Our findings suggest that anxiety sensitivity and panic-agoraphobic spectrum symptoms might be particularly relevant to understanding subtypes of PD
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