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The association between ADHD and eating disorders/pathology in adolescents: A systematic review

Open Journal of Epidemiology 2013年第4期3卷 193-202页

作者： carol curtin Sherry L. Pagoto Eric Mick Division of Behavioral and Preventive Medicine University of Massachusetts Medical School Worcester USA Family Medicine & Community Health E.K. Shriver Center University of Massachusetts Medical School Waltham USA Quantitative Health Sciences University of Massachusetts Medical School Worcester USA

Background: Attention-Deficit/Hyperactivity Disorder (ADHD), one of the most common neurodevelopmental conditions of childhood, is associated with high rates of mood and behavioral disorders. Preliminary evidence suggests that ADHD may also be associated with eating disorders (ED) or eating pathology (EP). This systematic review synthesizes the extant published literature on this association among youth ages 12-21 years. Methods: Literature searches were performed using Medline, Ovid/Psych Info, Google Scholar, and via manual inspection of bibliographies. Cross-sectional, case-control, and prospective studies published in English with sample sizes larger than 50, participant ages 12-21 years, and assessed ADHD and ED or EP, were considered for review. Case reports, feeding, and drug studies were excluded. Results: Preliminary searches yielded 337 articles;eight articles met inclusion/exclusion criteria. Two studies documented an association between ADHD and ED, and three studies found an association between ADHD and EP. Youth with ADHD were nearly 3 to 6 times more likely to develop an ED than youth without ADHD, and were also more likely to have higher rates of EP, body dissatisfaction, and desire to lose weight/ drive for thinness. Impulsivity was predictive of EP, and ADHD youth with co-occurring mood/behavioral disorders and punitive parental relationships were at higher risk. Conclusions: Five of eight studies documented an association between ADHD and ED or EP in adolescents. Future research is needed to confirm and refine further these findings. The findings have clinical implications, including the inclusion of ED/EP in screening and anticipatory guidance efforts. Evaluating whether medical management of ADHD may be efficacious in preventing and/or treating ED/EP is also warranted.

关键词： ADHD Adolescents Eating Disorders Eating Pathology

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Continuous Lumbar Plexus Catheter Removal in Postoperative Total Hip Replacement Patients Receiving Warfarin Thromboprophylaxis: A Retrospective Analysis

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Open Journal of Anesthesiology 2013年第6期3卷 293-297页

作者： Joseph Marino Jay curtin carol Patrick Kara Theal Cristina Sison George Koutsouras Scott Alpert W. Healy III Oonagh Dowling Renee Pekmezaris J. E. Chelly Biostatistics Unit The Feinstein Institute for Medical Research Manhasset USA Biostatistics Unit The Feinstein Institute for Medical Research Manhasset USA Department of Anesthesiology Franklin Hospital Medical Center Valley Stream USA Department of Anesthesiology Huntington Hospital Huntington USA Department of Cardiology Huntington Hospital Huntington USA Department of Information Services Huntington Hospital Huntington USA Department of Orthopedic Anesthesia and Acute Interventional Pain University of Pittsburgh School of Medicine Pittsburgh USA Department of Orthopedics Huntington Hospital Huntington USA Department of Population Health North Shore LIJ Health System Great Neck USA Department of Population Health North Shore LIJ Health System Great Neck USA

Background and Objectives: Based on the case reports of hemorrhagic complications, recommendations for the removal of lumbar plexus catheters in anticoagulated patients were created. These guidelines are controversial as they limit the use of lumbar plexus blocks in postoperative anticoagulated patients. This study was designed to evaluate the incidence of hemorrhagic complications and coagulation status using International Normalized Ratio (INR) at the time of lumbar plexus catheter removal in patients receiving warfarin after total hip replacement. Methods: A retrospective study of 371 patients on warfarin thromboprophylaxis who received continuous lumbar plexus catheters for postoperative analgesia after total hip surgery was performed. The primary outcome measure was the incidence of bleeding complications after catheter removal;secondary outcome measures included warfarin dose, bridge therapy, incidence of deep vein thrombosis, pulmonary embolism (DVT/PE) and INR values upon catheter removal. Results: Almost all lumbar plexus catheters (93%;344/371) were removed at 72 hours. At the time of catheter removal, mean INR was 1.99 [1.42-2.41] (p = 0.015);67% of patients had an INR > 1.5 and half of these patients had INRs between 2.0-3.0;5% had INR’s between 3.0-4.0. There were no adverse bleeding complications or nerve injury after the removal of catheters. Conclusions: We observed no incidence of bleeding after lumbar plexus catheter removal despite 67 % of patients demonstrating INR’s > 1.5. Our retrospective analysis illustrates the relative safety of catheter removal in anticoagulated patients and suggests that the removal of lumbar plexus catheters can be safely performed with an INR > 1.5 in patients receiving warfarin.

关键词： Lumbar Plexus Block Warfarin Prophylaxis Deep Vein Thrombosis Pulmonary Embolism

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