Eran Dolev

Sleep quality in children with attention deficit hyperactivity disorder: an actigraphic study.

Abstract  The aim of the present study was to compare the sleep of 12 children with attention deficit hyperactivity disorder (ADHD) with that of 12 normal controls. The children were examined in their natural environment, using continuous actigraphic monitoring over several consecutive nights, as well as undergoing subjective parental reports. It was hypothesized that children diagnosed with ADHD would suffer from reduced sleep quality than children without ADHD. This hypothesis was supported by the actigraphic measures, but not supported by the subjective parental reports. It was also found that the sleep quality of the two groups differed over the course of the night, which suggests a difference in sleep architecture. Various possible explanations for these findings, their implications regarding the relationship between sleep and ADHD, and the resulting treatment ramifications are discussed, and suggestions for further research are provided.

Drug-induced hypomagnesaemia : scope and management.

Nearly 50 medications have been implicated as inducing hypomagnesaemia, sometimes based on insufficient data regarding clinical significance and frequency of occurrence. In fact, clinical effects attributed to hypomagnaesemia have been reported in only 17 of these drugs. A considerable amount of literature relating to individual drugs has been published, yet a comprehensive overview of this issue is not available and the hypomagnesaemic effect of a drug could be either overemphasised or under-rated. In addition, there are neither guidelines regarding treatment, prevention and monitoring of drug-induced hypomagnesaemia nor agreement as to what serum level of magnesium may actually be defined as ‘hypomagnesaemia’.By compiling data from published papers, electronic databases, textbooks and product information leaflets, we attempted to assess the clinical significance of hypomagnesaemia induced by each drug. A practical approach for managing drug-induced hypomagnesaemia, incorporating both published literature and personal experience of the physician, is proposed. When drugs classified as inducing ‘significant’ hypomagnesaemia (cisplatin, amphotericin B, ciclosporin) are administered, routine magnesium monitoring is warranted, preventive treatment should be considered and treatment of hypomagnesaemia should be initiated with or without overt clinical manifestations. In drugs belonging to the ‘potentially significant’ category, among which are amikacin, gentamicin, laxatives, pentamidine, tobramycin, tacrolimus and carboplatin, magnesium monitoring is justified when either of the following occurs: clinical manifestations are apparent; persistent hypokalaemia, hypocalcaemia or alkalosis are present; other precipitating factors for hypomagnesaemia coexist; or treatment is with more than one potentially hypomagnesaemic drug. No preventive treatment is required and treatment should be initiated only if hypomagnesaemia is accompanied by symptoms or clinically significant relevant laboratory findings. In those drugs whose hypomagnesaemic effect is labelled as ‘questionable’, including furosemide and hydrochlorothiazide, routine monitoring and treatment are not required.

Use of Natural Substances in the Treatment of Renal Stones and Other Urinary Disorders in the Medieval Levant

Urinary disorders were common in the ancient world, especially in the Mediterranean region. In semi-arid zones and countries with unreliable water sources, renal stones and other urinary problems occur with greater frequency. A lack of water and correspondingly high levels of calcium saturation are among the main reasons for the formation of calcium sediments in the urinary tract, and it is hardly surprising, therefore, that many generations of physicians and healers have been called upon to treat these disorders, or at least alleviate the pain associated with them. Down the ages, many natural substances have been used for this purpose. This article focuses on 62 plants, 9 animal-based remedies, 1 mineral preparation and 4 medicinal substances of different or uncertain origin, traced in a recent survey of relevant historical literature (both medical and non-medical). Many of these materials, used to treat urinary disorders in the Levant between the 8th and the 18th centuries, had already been in use since the classical period, and several are still used today in traditional medicine.

Israeli Physicians' Performance after Sleep Deprived Situations - Differences among Male and Female Hospital Residents

Abstract This paper explores gender differences among hospital residents’ performance of clinical tasks in sleepderived situations. Two different research instruments were employed to investigate the physicians’ performance: an objective measure assessing the effects of sleep loss on performance by means of a computer game, and a subjective measure, a self-evaluation questionnaire investigating physicians’ assessments of the effects of sleep loss on their professional performance. The results reveal no significant differences in objective performance between men and women as obtained by the computer game after a night shift. However, significant gender differences in selfassessment appeared in the self-reported questionnaire in the domains of technical abilities, decision-making and general functioning. Women residents reported a significant decline in some components of their performance after a night shift, while male residents report only a marginal effect on their performance. The major contribution of this study is in its actual applications in developing optimal work schedules and organizational interventions to minimize fatigue and increase safety.

Is magnesium depletion the reason for ototoxicity caused by aminoglycosides

Aminoglycoside antibiotic drugs may cause ototoxicity and nephrotoxicity. Our hypothesis postulates that aminoglycosides cause ototoxicity by a mechanism of magnesium depletion in the hair cells of the cochlea. The same mechanism maybe responsible for nephrotoxicity caused by aminoglycosides.

Fluoride ion release and solubility of fluoride enriched interim cements

STATEMENT OF PROBLEM Interim and definitive restorations cemented with interim cements for a prolonged interval are susceptible to bacterial infiltration and caries formation. PURPOSE The purpose of this in vitro study was to evaluate the long-term fluoride release and solubility of aged ZnO-based interim cements enriched separately with 0.4% NaF and SnF2. MATERIAL AND METHODS Four different brands of cements (Tempbond, Tempbond NE, Procem, and Freegenol) were tested for fluoride release and solubility. For every test, 6 disk specimens of each cement with NaF and SnF2, and 6 with no fluoride enrichment (control) were fabricated, for a total of 72 specimens. The disks were incubated in deionized water. Fluoride ion release was recorded at 1, 7, 14, 21, 63, 91, and 182 days. Solubility was calculated as weight percent after 90 days of incubation. The data were analyzed by analysis of variance with repeated measures and the Tukey honestly significant difference post hoc test (P<.05). RESULTS Cements mixed with fluorides released fluoride ions for at least 182 days. Cements mixed with NaF released more fluoride ions than those mixed with SnF2 (P<.001). The cumulative release rates from all the tested cements mixed with either NaF or SnF2 were linear with respect to t(½) (r>.97), indicating a diffusion-controlled fluoride release. Cement and fluoride types were the main affecting factors in fluoride ion release. The addition of fluorides slightly increased the solubility of the cements. CONCLUSIONS Given their long-term sustained and diffusive controlled release, these fluorides, particularly NaF when mixed with ZnO-based interim cements, may be useful for caries prevention under provisionally cemented restorations.

Medicine and the Boer War. A Comment

The Boer War was the first war to be waged in the twentieth century. During this war both sides, the Boers and the British, used modern “high-velocity” weapons. However, whereas the Boers were armed with 7mm Mauser rifles, the British employed the 0.303 Lee Metford. The effect of these high-velocity weapons was less devastating than that of the weapons fired in previous wars. Both sides, it might be noted, usually refrained from using dumdum bullets.