Objectives To study the longitudinal course of sleep timing and circadian preferences in individuals with bipolar disorder (BP) compared to individuals with non-BP psychopathology and healthy controls. Methods Individuals with bipolar I and bipolar II disorder (n = 257), non-BP psychopathology (n = 105), and healthy controls (n = 55) (mean age 40.2 years, 21.3% male, 85.1% Caucasian) were followed on average every 27 months for a mean of four years. Sleep timing parameters and circadian preference were reported using the Sleep Timing Questionnaire and The Composite Scale for Morningness. Group comparisons were adjusted for multiple comparisons and between-group differences in demographic variables and psychopharmacological treatment. Results Regardless of their current mood state, individuals with BP showed more sleep onset latency (SOL), awakening after sleep onset (WASO), and evening preference in comparison to both individuals with non-BP psychopathology and healthy controls. Individuals with BP also showed less stability of bed and awakening times in comparison to the other two groups, though these results were dependent on mood state. Non-BP individuals only showed more WASO and less stability in bed and awakening times before work/school days than healthy controls. Adjusting for comorbid disorders yielded similar results. Within-group analyses found little to no effect of time and BP subtype on sleep timing and circadian preference. Conclusions Disturbances of sleep timing are prominent in individuals with BP. These disturbances are worse during mood episodes, but still apparent during euthymic periods. Evening preference was not associated with polarity type, or mood state in BP, suggesting that this characteristic may be a trait marker.

ObjectivesTo evaluate the possible role of silodosin (a highly selective α1A-adrenoceptor antagonist) in facilitating the passage of distal ureteric stones (DUS) in children, as the role of α-blockers as medical expulsive therapy is well known in adults.Patients and methodsIn all, 40 paediatric patients (27 boys and 13 girls) diagnosed with unilateral, single, radiopaque DUS of <10 mm were included in the study. Their mean (SD, range) age was 8.1 (2.7, 5–17) years. The patients were randomly divided into two groups: Group A, received silodosin 4 mg as a single bedtime dose; and Group B, received placebo as a single bedtime dose. Ibuprofen was prescribed to both groups on-demand for pain episode relief. Patients were followed up biweekly for 4 weeks. The stone expulsion time and rate, pain episodes, analgesic use, and any adverse effects were recorded.ResultsThe mean (SD) stone size in Group A was 6.6 (1.7) mm and in Group B was 6.7 (1.4) mm (P = 0.4). Two patients were lost to follow-up (one from each group), and one patient in Group A refused to complete the study. The stone-free rate at end of the 4-week treatment period was 88.8% in Group A vs 73.6% in Group B (P = 0.4). The mean (SD) stone expulsion time was 7.0 (4.3) vs 10.4 (4.7) days in groups A and B, respectively (P = 0.02). The mean (SD) number of pain episodes requiring ibuprofen was 2.3 (1.4) vs 4.7 (2.6) episodes in groups A and B, respectively (P < 0.001). Adverse effects (headache and dizziness) were recorded in three patients (16.7%) in Group A, which were mild and none of them discontinued treatment, whilst no adverse effects were recorded in Group B.ConclusionsThe data in the present study show that silodosin can be safely used in the treatment of DUS in children for decreasing time to stone expulsion, pain episodes, and analgesic requirement.

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The management of pilonidal sinus with excision under local anesthesia and application of a fibrin glue is simple and reduces postoperative disability and disruption of patient social life.

In the present paper, an experimental work was carried out to study the effect of ground waste tire rubber addition on the mechanical properties and impact resistance of normal strength concrete (NSC) with and without silica fume. Three different volume ratios of cnunb rubber (lo%, 20%, and 30%) were used as a partial replacement of sand. Two different sizes of cylinders were tested , under indirect tension test to study the size effect. Impact compression according to ACI Committee 544's repeated drop-weight impact test was carried out on discs of 150 mm diameter ,. ' ana 63 mm height. Test results showed that, the replacement of fine aggregate by 10% crumb ,. rubber caused a small decrease in concrete compressive strength. The presence of crumb rubber of :,. small size in concrete increased its resistance to crack initiation under impact load. Tbe rubber of small sue bas no varticle brid.eiua effect, hence, the mode of failure of rubberized concrete under static and impact ~ompression&a~ the s&e as that of plain concrete. The ACI impact test failed to differentiate between the impact resistance of rubberized concretes with different rubber contents.