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Article ; Online: Generalised Image Processing Method for Quantitative Analysis of Nucleus, Cell and Focal Adhesion Clusters

Nair Rajasree Padmakumari Hemachandran / Menon Rohit / Kemkemer Ralf

Current Directions in Biomedical Engineering, Vol 7, Iss 2, Pp 558-

2021 Volume 561

Abstract: Focal adhesion clusters (FAC) are dynamic and complex structures that help cells to sense physicochemical properties of their environment. Research in biomaterials, cell adhesion or cell migration often involves the visualization of FAC by fluorescence ... ...

Abstract	Focal adhesion clusters (FAC) are dynamic and complex structures that help cells to sense physicochemical properties of their environment. Research in biomaterials, cell adhesion or cell migration often involves the visualization of FAC by fluorescence staining and microscopy, which necessitates quantitative analysis of FAC and other cell features in microscopy images using image processing. Fluorescence microscopy images of human umbilical vein endothelial cells (HUVEC) obtained at 63x magnification were quantitatively analysed using ImageJ software. A generalised algorithm for selective segmentation and morphological analysis of FAC, nucleus and cell morphology is implemented. Further, a method for discrimination of FAC near the nucleus and around the periphery is implemented using masks. Our algorithm is able to effectively quantify different morphological characteristics of cell components and shows a high sensitivity and specificity while providing a modular software implementation.
Keywords	focal adhesion clusters ; algorithm ; fluorescence ; quantitative analysis ; imagej ; sensitivity ; specificity ; location selective segmentation ; masks ; Medicine ; R
Subject code	669
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
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Article ; Online: Does evidence support the use of supplements to aid in BP control?

Gibbs, Lawrence M / Nair, Rajasree J / Nashelsky, Joan

The Journal of family practice

2020 Volume 69, Issue 7, Page(s) E14–E16

MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Arginine/therapeutic use ; Beta vulgaris ; Biological Products/therapeutic use ; Blood Pressure/drug effects ; Chocolate ; Dietary Supplements ; Fatty Acids, Omega-3/therapeutic use ; Female ; Garlic ; Humans ; Hypertension/drug therapy ; Hypertension/prevention & control ; Linseed Oil/therapeutic use ; Male ; Middle Aged ; Olea
Chemical Substances	Biological Products ; Fatty Acids, Omega-3 ; Linseed Oil (8001-26-1) ; Arginine (94ZLA3W45F)
Language	English
Publishing date	2020-09-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	197883-4
ISSN	1533-7294 ; 0094-3509
ISSN (online)	1533-7294
ISSN	0094-3509
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Zs.A 1274: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Follicular dendritic cell sarcoma of the thigh: a clinicopathological report and management approach.

Rajan, Rajasree / Roshni, Divya Gireesan / Mathew, Suzann Mary / Jojo, Annie / Nair, Haridas Mohanachandran / Kottarathil, Vijayakumar Dehannathparambil

BMJ case reports

2022 Volume 15, Issue 4

Abstract: Follicular dendritic cells are antigen-presenting immune accessory cells of mesenchymal origin. Follicular dendritic cell sarcomas (FDCS) typically occur in nodal and extranodal sites. However, presentation in the extremity has rarely been reported. A ... ...

Abstract	Follicular dendritic cells are antigen-presenting immune accessory cells of mesenchymal origin. Follicular dendritic cell sarcomas (FDCS) typically occur in nodal and extranodal sites. However, presentation in the extremity has rarely been reported. A woman in her 60s had a painless, slow-growing right posterior thigh swelling, which had been present for 9 months. Imaging revealed a subcutaneous lesion in the posterior aspect of the right mid-thigh. Fine-needle aspiration cytology from the lesion was suggestive of a malignant spindle cell neoplasm, and she underwent its wide local excision. Immunohistochemistry showed expression of epithelial membrane antigen and CD35, but an absence of cytokeratin, desmin, CD23 and S100. The Ki-67 index was low and a diagnosis of FDCS was made. The lack of clinical guidelines was a challenge in the treatment of this rare case. A multidisciplinary board discussion played a critical role in the planning of the patient's adjuvant treatment.
MeSH term(s)	Biopsy, Fine-Needle ; Dendritic Cell Sarcoma, Follicular/diagnosis ; Dendritic Cell Sarcoma, Follicular/surgery ; Female ; Humans ; Immunohistochemistry ; Sarcoma ; Thigh/pathology
Language	English
Publishing date	2022-04-26
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-244812
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Article ; Online: Sodium glucose co-transporter 2 inhibition increases epidermal growth factor expression and improves outcomes in patients with type 2 diabetes.

Sen, Taha / Ju, Wenjun / Nair, Viji / Ladd, Patricia / Menon, Rajasree / Otto, Edgar A / Pyle, Laura / Vigers, Tim / Nelson, Robert G / Arnott, Clare / Neal, Bruce / Hansen, Michael K / Kretzler, Matthias / Bjornstad, Petter / Heerspink, Hiddo J L

Kidney international

2023 Volume 104, Issue 4, Page(s) 828–839

Abstract: Underlying molecular mechanisms of the kidney protective effects of sodium glucose co-transporter 2 (SGLT2) inhibitors are not fully elucidated. Therefore, we studied the association between urinary epidermal growth factor (uEGF), a mitogenic factor ... ...

Abstract	Underlying molecular mechanisms of the kidney protective effects of sodium glucose co-transporter 2 (SGLT2) inhibitors are not fully elucidated. Therefore, we studied the association between urinary epidermal growth factor (uEGF), a mitogenic factor involved in kidney repair, and kidney outcomes in patients with type 2 diabetes (T2D). The underlying molecular mechanisms of the SGLT2 inhibitor canagliflozin on EGF using single-cell RNA sequencing from kidney tissue were examined. Urinary EGF-to-creatinine ratio (uEGF/Cr) was measured in 3521 CANagliflozin cardioVascular Assessment Study (CANVAS) participants at baseline and week 52. Associations of uEGF/Cr with kidney outcome were assessed using multivariable-adjusted Cox regression models. Single-cell RNA sequencing was performed using protocol kidney biopsy tissue from ten young patients with T2D on SGLT2i, six patients with T2D on standard care only, and six healthy controls (HCs). In CANVAS, each doubling in baseline uEGF/Cr was associated with a 12% (95% confidence interval 1-22) decreased risk of kidney outcome. uEGF/Cr decreased after 52 weeks with placebo and remained stable with canagliflozin (between-group difference +7.3% (2.0-12.8). In young persons with T2D, EGF mRNA was primarily expressed in the thick ascending loop of Henle. Expression in biopsies from T2D without SGLT2i was significantly lower compared to HCs, whereas treatment with SGLT2i increased EGF levels closer to the healthy state. In young persons with T2D without SGLT2i, endothelin-1 emerged as a key regulator of the EGF co-expression network. SGLT2i treatment was associated with a shift towards normal EGF expression. Thus, decreased uEGF represents increased risk of kidney disease progression in patients with T2D. Canagliflozin increased kidney tissue expression of EGF and was associated with a downstream signaling cascade linked to tubular repair and reversal of tubular injury.
MeSH term(s)	Humans ; Canagliflozin/pharmacology ; Canagliflozin/therapeutic use ; Cardiovascular Diseases/drug therapy ; Diabetes Mellitus, Type 2/complications ; Epidermal Growth Factor/genetics ; Glucose ; Sodium/metabolism ; Sodium-Glucose Transporter 2/genetics ; Sodium-Glucose Transporter 2/metabolism ; Sodium-Glucose Transporter 2 Inhibitors/pharmacology ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
Chemical Substances	Canagliflozin (0SAC974Z85) ; Epidermal Growth Factor (62229-50-9) ; Glucose (IY9XDZ35W2) ; Sodium (9NEZ333N27) ; Sodium-Glucose Transporter 2 ; Sodium-Glucose Transporter 2 Inhibitors
Language	English
Publishing date	2023-08-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2023.07.007
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Article ; Online: Molecular Characterization of Membranous Nephropathy.

Sealfon, Rachel / Mariani, Laura / Avila-Casado, Carmen / Nair, Viji / Menon, Rajasree / Funk, Julien / Wong, Aaron / Lerner, Gabriel / Hayashi, Norifumi / Troyanskaya, Olga / Kretzler, Matthias / Beck, Laurence H

Journal of the American Society of Nephrology : JASN

2022 Volume 33, Issue 6, Page(s) 1208–1221

Abstract: Background: Molecular characterization of nephropathies may facilitate pathophysiologic insight, development of targeted therapeutics, and transcriptome-based disease classification. Although membranous nephropathy (MN) is a common cause of adult-onset ... ...

Abstract	Background: Molecular characterization of nephropathies may facilitate pathophysiologic insight, development of targeted therapeutics, and transcriptome-based disease classification. Although membranous nephropathy (MN) is a common cause of adult-onset nephrotic syndrome, the molecular pathways of kidney damage in MN require further definition. Methods: We applied a machine-learning framework to predict diagnosis on the basis of gene expression from the microdissected kidney tissue of participants in the Nephrotic Syndrome Study Network (NEPTUNE) cohort. We sought to identify differentially expressed genes between participants with MN versus those of other glomerulonephropathies across the NEPTUNE and European Renal cDNA Bank (ERCB) cohorts, to find MN-specific gene modules in a kidney-specific functional network, and to identify cell-type specificity of MN-specific genes using single-cell sequencing data from reference nephrectomy tissue. Results: Glomerular gene expression alone accurately separated participants with MN from those with other nephrotic syndrome etiologies. The top predictive classifier genes from NEPTUNE participants were also differentially expressed in the ERCB participants with MN. We identified a signature of 158 genes that are significantly differentially expressed in MN across both cohorts, finding 120 of these in a validation cohort. This signature is enriched in targets of transcription factor NF-κB. Clustering these MN-specific genes in a kidney-specific functional network uncovered modules with functional enrichments, including in ion transport, cell projection morphogenesis, regulation of adhesion, and wounding response. Expression data from reference nephrectomy tissue indicated 43% of these genes are most highly expressed by podocytes. Conclusions: These results suggest that, relative to other glomerulonephropathies, MN has a distinctive molecular signature that includes upregulation of many podocyte-expressed genes, provides a molecular snapshot of MN, and facilitates insight into MN's underlying pathophysiology.
MeSH term(s)	Adult ; Glomerulonephritis, Membranous/genetics ; Glomerulonephritis, Membranous/metabolism ; Humans ; Kidney/metabolism ; Kidney Diseases/metabolism ; Kidney Glomerulus/metabolism ; Nephrotic Syndrome/genetics ; Nephrotic Syndrome/metabolism ; Podocytes/metabolism
Language	English
Publishing date	2022-04-27
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1085942-1
ISSN	1533-3450 ; 1046-6673
ISSN (online)	1533-3450
ISSN	1046-6673
DOI	10.1681/ASN.2021060784
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Zs.A 3344: Show issues

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Article ; Online: SGLT2 inhibitors mitigate kidney tubular metabolic and mTORC1 perturbations in youth-onset type 2 diabetes.

Schaub, Jennifer A / AlAkwaa, Fadhl M / McCown, Phillip J / Naik, Abhijit S / Nair, Viji / Eddy, Sean / Menon, Rajasree / Otto, Edgar A / Demeke, Dawit / Hartman, John / Fermin, Damian / O'Connor, Christopher L / Subramanian, Lalita / Bitzer, Markus / Harned, Roger / Ladd, Patricia / Pyle, Laura / Pennathur, Subramaniam / Inoki, Ken /

Hodgin, Jeffrey B / Brosius, Frank C / Nelson, Robert G / Kretzler, Matthias / Bjornstad, Petter

The Journal of clinical investigation

2023 Volume 133, Issue 5

Abstract: The molecular mechanisms of sodium-glucose cotransporter-2 (SGLT2) inhibitors (SGLT2i) remain incompletely understood. Single-cell RNA sequencing and morphometric data were collected from research kidney biopsies donated by young persons with type 2 ... ...

Abstract	The molecular mechanisms of sodium-glucose cotransporter-2 (SGLT2) inhibitors (SGLT2i) remain incompletely understood. Single-cell RNA sequencing and morphometric data were collected from research kidney biopsies donated by young persons with type 2 diabetes (T2D), aged 12 to 21 years, and healthy controls (HCs). Participants with T2D were obese and had higher estimated glomerular filtration rates and mesangial and glomerular volumes than HCs. Ten T2D participants had been prescribed SGLT2i (T2Di[+]) and 6 not (T2Di[-]). Transcriptional profiles showed SGLT2 expression exclusively in the proximal tubular (PT) cluster with highest expression in T2Di(-) patients. However, transcriptional alterations with SGLT2i treatment were seen across nephron segments, particularly in the distal nephron. SGLT2i treatment was associated with suppression of transcripts in the glycolysis, gluconeogenesis, and tricarboxylic acid cycle pathways in PT, but had the opposite effect in thick ascending limb. Transcripts in the energy-sensitive mTORC1-signaling pathway returned toward HC levels in all tubular segments in T2Di(+), consistent with a diabetes mouse model treated with SGLT2i. Decreased levels of phosphorylated S6 protein in proximal and distal tubules in T2Di(+) patients confirmed changes in mTORC1 pathway activity. We propose that SGLT2i treatment benefits the kidneys by mitigating diabetes-induced metabolic perturbations via suppression of mTORC1 signaling in kidney tubules.
MeSH term(s)	Animals ; Mice ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/genetics ; Diabetes Mellitus, Type 2/metabolism ; Kidney/metabolism ; Kidney Glomerulus/metabolism ; Sodium-Glucose Transporter 2/genetics ; Sodium-Glucose Transporter 2 Inhibitors/pharmacology ; Humans ; Child ; Adolescent ; Young Adult ; Mechanistic Target of Rapamycin Complex 1
Chemical Substances	Sodium-Glucose Transporter 2 ; Sodium-Glucose Transporter 2 Inhibitors ; SLC5A2 protein, human ; Mechanistic Target of Rapamycin Complex 1 (EC 2.7.11.1)
Language	English
Publishing date	2023-03-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	3067-3
ISSN	1558-8238 ; 0021-9738
ISSN (online)	1558-8238
ISSN	0021-9738
DOI	10.1172/JCI164486
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Article ; Online: Adverse events associated with Covishield vaccination among healthcare workers in a tertiary hospital in South India.

T Sathyapalan, Dipu / Moni, Merlin / Prasanna, Preetha / Marwaha, Vishal / Bala Madathil, Sai / Edathadathil, Fabia / Jose, Sony A / Pavithran, Sheela / Muralikrishanan, Rajasree / Ramachandran, Nigith / P R, Roshni / T S, Tinu / Nair, Anjana S / Kuriachan, Sanitha / Louis Palatty, Princy

Vaccine: X

2022 Volume 12, Page(s) 100210

Abstract: Background: Vaccination is the most important prophylactic measure taken to curb COVID-19 pandemics. This study was undertaken to throw light on the safety of Covishield vaccine among health care workers (HCWs) and to assess the co-variates associated ... ...

Abstract	Background: Vaccination is the most important prophylactic measure taken to curb COVID-19 pandemics. This study was undertaken to throw light on the safety of Covishield vaccine among health care workers (HCWs) and to assess the co-variates associated with incidence of adverse events. Methods: This prospective observational study was conducted in a tertiary care center in South India as part of the HCW vaccination drive. All consenting HCWs who received the first dose of Covishield vaccine and developed ADRs were included in this study. After vaccination, all beneficiaries were monitored for AEFI for a period of half an hour and later followed up through telephone and google survey forms on day 2 and day 7 of vaccination. The data was subsequently collated into spreadsheet format and analyzed. Results: The study included 1264 consenting healthcare workers who were predominantly youth, aged 15-24 years (n = 583, 46 %) and with a female preponderance of 76 % (n = 960). Past history of COVID-19 infections was reported among 4.6 % (58) of the study population. Postvaccination symptoms were majorly reported during the first (40 %) and second day (44 %) after vaccination with a high prevalence of both local (n = 1083, 85 %) and systemic symptoms (n = 1065, 84 %). The mean duration of symptoms was observed to be 1.4 ± 0.81 days post vaccination. Symptoms were observed significantly high among females (76.7 %, p = 0.013). The prevalence of systemic (88 % vs 80 %) (p < 0.001) and allergic symptoms (7 % vs 3 %; p = 0.03) were observed to be significantly high among respondents with <25 years of age. The systemic and allergic symptoms following vaccination were reported to be low among healthcare workers who had a previous history of COVID-19 infection. Conclusion: COVID vaccination has been observed to be safe and well tolerated with more systemic symptoms reported among younger age group and females.
Language	English
Publishing date	2022-08-28
Publishing country	England
Document type	Journal Article
ISSN	2590-1362
ISSN (online)	2590-1362
DOI	10.1016/j.jvacx.2022.100210
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Article ; Online: Molecular programs associated with glomerular hyperfiltration in early diabetic kidney disease.

Stefansson, Vidar T N / Nair, Viji / Melsom, Toralf / Looker, Helen C / Mariani, Laura H / Fermin, Damian / Eichinger, Felix / Menon, Rajasree / Subramanian, Lalita / Ladd, Patricia / Harned, Roger / Harder, Jennifer L / Hodgin, Jeffrey B / Bjornstad, Petter / Nelson, Peter J / Eriksen, Bjørn O / Nelson, Robert G / Kretzler, Matthias

Kidney international

2022 Volume 102, Issue 6, Page(s) 1345–1358

Abstract: Hyperfiltration is a state of high glomerular filtration rate (GFR) observed in early diabetes that damages glomeruli, resulting in an iterative process of increasing filtration load on fewer and fewer remaining functional glomeruli. To delineate ... ...

Abstract	Hyperfiltration is a state of high glomerular filtration rate (GFR) observed in early diabetes that damages glomeruli, resulting in an iterative process of increasing filtration load on fewer and fewer remaining functional glomeruli. To delineate underlying cellular mechanisms of damage associated with hyperfiltration, transcriptional profiles of kidney biopsies from Pima Indians with type 2 diabetes with or without early-stage diabetic kidney disease were grouped into two hyperfiltration categories based on annual iothalamate GFR measurements. Twenty-six participants with a peak GFR measurement within two years of biopsy were categorized as the hyperfiltration group, and 26 in whom biopsy preceded peak GFR by over two years were considered pre-hyperfiltration. The hyperfiltration group had higher hemoglobin A1c, higher urine albumin-to-creatinine ratio, increased glomerular basement membrane width and lower podocyte density compared to the pre-hyperfiltration group. A glomerular 1240-gene transcriptional signature identified in the hyperfiltration group was enriched for endothelial stress response signaling genes, including endothelin-1, tec-kinase and transforming growth factor-β1 pathways, with the majority of the transcripts mapped to endothelial and inflammatory cell clusters in kidney single cell transcriptional data. Thus, our analysis reveals molecular pathomechanisms associated with hyperfiltration in early diabetic kidney disease involving putative ligand-receptor pairs with downstream intracellular targets linked to cellular crosstalk between endothelial and mesangial cells.
MeSH term(s)	Humans ; Diabetic Nephropathies/genetics ; Diabetic Nephropathies/complications ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/genetics ; Diabetes Mellitus, Type 2/pathology ; Kidney Glomerulus/pathology ; Glomerular Filtration Rate ; Glycated Hemoglobin/metabolism
Chemical Substances	Glycated Hemoglobin A
Language	English
Publishing date	2022-08-31
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2022.07.033
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Article ; Online: Glomerular endothelial cell-podocyte stresses and crosstalk in structurally normal kidney transplants.

Menon, Rajasree / Otto, Edgar A / Berthier, Celine C / Nair, Viji / Farkash, Evan A / Hodgin, Jeffrey B / Yang, Yingbao / Luo, Jinghui / Woodside, Kenneth J / Zamani, Haniyeh / Norman, Silas P / Wiggins, Roger C / Kretzler, Matthias / Naik, Abhijit S

Kidney international

2021 Volume 101, Issue 4, Page(s) 779–792

Abstract: Increased podocyte detachment begins immediately after kidney transplantation and is associated with long-term allograft failure. We hypothesized that cell-specific transcriptional changes in podocytes and glomerular endothelial cells after ... ...

Abstract	Increased podocyte detachment begins immediately after kidney transplantation and is associated with long-term allograft failure. We hypothesized that cell-specific transcriptional changes in podocytes and glomerular endothelial cells after transplantation would offer mechanistic insights into the podocyte detachment process. To test this, we evaluated cell-specific transcriptional profiles of glomerular endothelial cells and podocytes from 14 patients of their first-year surveillance biopsies with normal histology from low immune risk recipients with no post-transplant complications and compared these to biopsies of 20 healthy living donor controls. Glomerular endothelial cells from these surveillance biopsies were enriched for genes related to fluid shear stress, angiogenesis, and interferon signaling. In podocytes, pathways were enriched for genes in response to growth factor signaling and actin cytoskeletal reorganization but also showed evidence of podocyte stress as indicated by reduced nephrin (adhesion protein) gene expression. In parallel, transcripts coding for proteins required to maintain podocyte adherence to the underlying glomerular basement membrane were downregulated, including the major glomerular podocyte integrin α3 and the actin cytoskeleton-related gene synaptopodin. The reduction in integrin α3 protein expression in surveillance biopsies was confirmed by immunoperoxidase staining. The combined growth and stress response of patient allografts post-transplantation paralleled similar changes in a rodent model of nephrectomy-induced glomerular hypertrophic stress that progress to develop proteinuria and glomerulosclerosis with shortened kidney life span. Thus, even among patients with apparently healthy allografts with no detectable histologic abnormality including alloimmune injury, transcriptomic changes reflecting cell stresses are already set in motion that could drive hypertrophy-associated glomerular disease progression.
MeSH term(s)	Endothelial Cells ; Female ; Glomerular Basement Membrane/pathology ; Humans ; Hypertrophy ; Integrin alpha3/metabolism ; Kidney Diseases/pathology ; Kidney Transplantation/adverse effects ; Male ; Podocytes/pathology
Chemical Substances	Integrin alpha3
Language	English
Publishing date	2021-12-22
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2021.11.031
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Article ; Online: Management of attention-deficit hyperactivity disorder in adults

Rajasree Nair / Shannon B Moss

Neuropsychiatric Disease and Treatment, Vol 2009, Iss default, Pp 421-

focus on methylphenidate hydrochloride

2009 Volume 432

Abstract: Rajasree Nair, Shannon B MossBaylor Family Medicine Residency at Garland, Garland, Texas ...

Abstract	Rajasree Nair, Shannon B MossBaylor Family Medicine Residency at Garland, Garland, Texas, USAAbstract: Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in young adults and causes significant psychosocial impairment and economic burden to society. Because of the paucity of long-term evidence and lack of national guidelines for diagnosis and management of adult ADHD, most of the data are based on experience derived from management of childhood ADHD. This article reviews the current evidence for the diagnosis and management of adult ADHD with special emphasis on the role of methylphenidate hydrochloride preparations in its treatment. Methylphenidate hydrochloride, a stimulant that acts through the dopaminergic and adrenergic pathways, has shown more than 75% efficacy in controlling the symptoms of adult ADHD. Although concern for diversion of the drug exists, recent data have shown benefits in preventing substance use disorders in patients with adult ADHD.Keywords: adult ADHD, treatment, stimulants, methylphenidate hydrochloride
Keywords	Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Neurology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	150
Language	English
Publishing date	2009-08-01T00:00:00Z
Publisher	Dove Press
Document type	Article ; Online
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