[The Prevalence of Attention Deficit/Hyperactivity Disorder (ADHD) Among Adolescents in Stationary Rehabilitation]. / Die Prävalenz der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Erwachsenenalter bei Patienten in der stationären Rehabilitation.

BACKGROUND: ADHD in adulthood is assumed to be a positive predictor for many comorbid diseases and impairments affecting all domains of life, particularly career performance. Participation in social and professional life is limited for populations which qualify for rehabilitation programs, and thus the prevalence of ADHD is presumably also higher in these populations. METHOD: To estimate the prevalence of ADHD in a population undergoing rehabilitation, 1010 people aged 18 to 75 years were screened for the presence of ADHD in adulthood. Additional impairments were measured and compared to a group of non ADHD participants. RESULTS: As expected a higher prevalence of ADHD was found in the population undergoing rehabilitation than in the general population (10.5%) Participants with ADHD who had recently begun rehabilitation seemed to have more impairments than non ADHD-participants. Participants with ADHD who were near the end of rehabilitation were more severely impaired in their capacity to reintegrate into their previous occupation, but not for the general employment market. CONCLUSION: Adult ADHD should be more closely investigated, especially in rehabilitation programs. Affected clients not only had more severe impairments, but more often had a profession that did not fit their capability.

Evaluative conditioning increases with temporal contiguity. The influence of stimulus order and stimulus interval on evaluative conditioning.

Evaluative conditioning (EC) is a change in valence that is due to pairing a conditioned stimulus (CS) with another, typically valent, unconditioned stimulus (US). This paper investigates how basic presentation parameters moderate EC effects. In two studies we tested the effectiveness of different temporal relations of the CS and the US, that is, the order in which the stimuli were presented and the temporal distance between them. Both studies showed that the size of EC effects was independent of the presentation order of CS and US within a stimulus pair. Contrary to classical conditioning effects, EC effects are thus not most pronounced after CS-first presentations. Furthermore, as shown in Experiment 2, EC effects increased in magnitude as the temporal interval between CS and US presentations decreased. Experiment 1 showed largest EC effects in the condition with simultaneous presentations - which can be seen as the condition with the temporally closest presentation. In this Experiment stimuli were presented in two different modalities, which might have facilitated simultaneous processing. In Experiment 2, in which all stimuli were presented visually, this advantage of simultaneous presentation was not found. We discuss practical and theoretical implications of our findings.

Regulation of podoplanin expression by microRNA-29b associates with its antiapoptotic effect in angiotensin II-induced injury of human podocytes.

BACKGROUND: Angiotensin (Ang)II is involved in induction of proteinuria, renal injury, and apoptosis and thus a major contributor to the development of chronic kidney disease. Podocytes are of major importance for the pathogenesis of several kidney diseases. Decrease of podoplanin (PDPN) in podocytes and podocyte loss has been associated with the development of proteinuria. Little is known about the regulation and biological function of PDPN in podocytes and its role in AngII-mediated kidney damage. Here, we determined the influence of AngII on the expression of PDPN, microRNA (miRNA)-29b and miRNA-497 in human podocytes. Further, we analyzed the impact of small interfering RNA-mediated downregulation of PDPN on AngII-induced apoptosis and viability. Moreover, we characterized the role of miRNA-29b and miRNA-497 in expression regulation of PDPN. METHODS: Cell viability and apoptosis were determined by functional assays. Expression analyses were done via Real-Time PCR and western blot analyses. Dual luciferase assay was performed to characterize miRNA-mediated expression control. RESULTS: AngII increased the expression of miRNA-29b and reduced PDPN. Small interfering RNA-mediated downregulation of PDPN increased proapoptotic caspase-3 activation and cytochrome C translocation, whereas cell viability and Akt phosphorylation were reduced in AngII-stimulated podocytes. In contrast to miRNA-497, transfection of cells with miRNA-29b mimics significantly decreased PDPN. Cotransfection of cells with miRNA-29b and a dual luciferase reporter vector decreased the luciferase activity compared with controls. CONCLUSION: These data demonstrate the posttranscriptional control of PDPN expression by miRNA-29b and support a role of PDPN as an antiapoptotic prosurvival factor in AngII-induced injury of human podocytes.

Metformin modulates apoptosis and cell signaling of human podocytes under high glucose conditions.

Diabetic nephropathy, which is associated with loss of human (h) podocytes (PC), is a major complication in diabetes mellitus. High-glucose modulates AMP-activated protein kinase (AMPK) signaling and cell apoptosis. Metformin has been demonstrated to reduce apoptosis and albuminuria in type 2 diabetes. Here, we examined the effect of metformin on cell apoptosis and on pro-/anti-apoptotic signaling in hPC. Expression analyses were done by real-time polymerase chain reaction and western blotting. Moreover, a functional apoptosis assay was performed in hPC. Determination of kinase activation by phosphorylation was done via immunodetection analyses and digital quantification. We found that hPC express organic cation transporter 1 which is the major uptake transporter of metformin. High-glucose reduced AMPK phosphorylation and induced mammalian target of rapamycin (mTOR) activation in podocytes, which was abolished and reversed by pre-treatment with metformin. Furthermore, metformin reduced high-glucose-induced podocytes apoptosis in a concentration-dependent manner. In summary, metformin exhibits an anti-apoptotic impact on podocytes under high-glucose conditions via activation of AMPK and inhibition of mTOR signaling. These data support a beneficial effect of metformin in diabetic nephropathy.

Development of progressive albuminuria in male Munich Wistar Frömter rats is androgen dependent.

Munich Wistar Frömter (MWF) rats develop spontaneous albuminuria that is linked to autosomal genetic loci and inherit a nephron deficit in both female and male animals, respectively. However, albuminuria and kidney damage are clearly more pronounced in males. Here we tested whether androgens and the androgen receptor influence albuminuria in male MWF. We first demonstrated in a pilot study that orchiectomy (Ox) of male MWF led to a significant suppression of urinary albumin excretion (UAE), while continuous testosterone supplementation in MWF Ox led to UAE levels similar to sham-operated (Sham) MWF rats. Subsequently, we performed a comparative main study between male MWF and normal Wistar rats to evaluate the effect of the androgen receptor on UAE development in adult animals up to the age of 18 wk. MWF Sham developed a marked increase in UAE compared with Wistar Sham (48.30 ± 6.16 vs. 0.42 ± 0.08 mg/24 h, P < 0.0001). UAE was significantly lower in MWF Ox compared with MWF Sham (-55%, P < 0.0001). In MWF Ox animals supplemented with testosterone and treated with the androgen receptor antagonist flutamide (OxTF) UAE at 18 wk was even lower compared with MWF Ox (-71%, P < 0.01) and similar to age-matched female MWF. The mRNA expression of renal tubular injury markers Kim1 and NGAL was increased in MWF Sham compared with Wistar Sham (P < 0.0008, respectively) and expression decreased significantly in MWF OxTF (P < 0.0004, respectively). Thus, the sexual dimorphism in albuminuria development in MWF can be attributed to testosterone and the androgen receptor in male rats.

Recovery index, attentiveness and state of memory after xenon or isoflurane anaesthesia: a randomized controlled trial.

BACKGROUND: Performance of patients immediately after anaesthesia is an area of special interest and so a clinical trial was conducted to compare Xenon with Isoflurane anaesthesia. In order to assess the early cognitive recovery the syndrome short test (SST) according to Erzigkeit (Geromed GmbH) was applied. METHODS: ASA I and II patients undergoing long and short surgical interventions were randomised to receive either general anaesthesia with Xenon or Isoflurane. The primary endpoint was the validated SST which covering memory disturbances and attentiveness. The test was used on the day prior to intervention, one and three hours post extubation. The secondary endpoint was the recovery index (RI) measured after the end of the inhalation of Xenon or Isoflurane. In addition the Aldrete score was evaluated up to 180 min. On the first post-operative day the patients rated the quality of the anaesthetic using a scoring system from 1-6. RESULTS: The demographics of the groups were similar. The sum score of the SST delivered a clear trend one hour post extubation and a statistically significant superiority for Xenon three hours post extubation (p < 0.01). The RI likewise revealed a statistically significant superiority of Xenon 5 minutes post extubation (p < 0.01). The Aldrete score was significantly higher for 45 min. The scoring system results were also better after Xenon anaesthesia (p < 0.001). CONCLUSIONS: The results show that recovery from anaesthesia and the early return of post-operative cognitive functions are significantly better after Xenon anaesthesia compared to Isoflurane. The results of the RI for Xenon are similar with the previously published results. TRIAL REGISTRATION: The trial was registered with the number ISRCTN01110844 http://www.controlled-trials.com/isrctn/pf/01110844.