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At least 865 records · Page 48Linked to original sources
PubMed2002

Transcatheter closure of atrial septal defect and patent foramen ovale in adult patients using the Amplatzer occlusion device: no evidence for thrombus deposition with antiplatelet agents.

Transcatheter closure of atrial septal defect (ASD) and patent foramen ovale (PFO) using the Amplatzer septal occluder (AGA Medical, Minneapolis, Minn) is an alternative to surgical closure. There are only limited data on the thrombogenic potential of the device. Thirty-seven patients (14 men, 23 women) underwent device closure of their ASD (n = 21) or PFO (n = 16) at a mean age of 47 +/- 14 years (range, 18-72). The device was successfully deployed in all patients. Thirty-three of 37 patients received antiplatelet therapy with clopidogrel bisulfate and aspirin for a total of 6 months. Four patients in atrial fibrillation were also anticoagulated (international normalized ratio 2.0 to 3.0). No thrombus was detected in any patient on either side of the device by transthoracic and transesophageal echocardiography and there were no cases of symptomatic thromboembolism. Right-to-left interatrial shunting was diagnosed by contrast transesophageal echocardiography with the Valsalva's maneuver. At 1-month follow-up, minimal right-to-left shunting was detected in 6 patients (2 PFO, 4 ASD). Two patients (PFO) had minimal shunting at 1 month but not at 6 months. In 3 patients (ASD), inducible right-to-left shunting persisted at 6 months. In conclusion, our results obtained from a modest number of patients indicate that antiplatelet therapy is safe and effective in preventing thrombus formation on the septal occluder surface.

Adolescent↗
PubMedDate not supplied

Arthroscopic subacromial decompression.

In this study, we analyzed the results of two series of patients treated for impingement syndrome by undergoing arthroscopic subacromial decompression (ASD). Patients had not responded to nonoperative treatment. Group 1 included 112 consecutive patients (average age, 41 years) with 96 (77%) patients available for 2-year follow-up. Group 2 (28 patients, 29 shoulders; average age, 43 years; range, 22 to 72) had ASD and the subacromial space digitally palpated to determine if adequate decompression was performed. Twenty-two (85%) of 26 shoulders were available for follow-up. At follow-up, pain, function, range of motion, strength, impingement signs, and patient satisfaction were assessed. In group 1, according to the Neer criteria, 48% of the patients were graded as satisfactory and 52% unsatisfactory. Workers' Compensation patients had a satisfactory rate of 32%, whereas non-Workers' Compensation patients had a satisfactory rate of 59%. Twenty patients had open acromioplasty after ASD. Inadequate decompression was noted in 14 of 20 failed patients. In group 2, 86% of the patients were graded as satisfactory according to the Neer criteria, with 14% unsatisfactory, which included the 2 failures. The 2 (9%) of 22 shoulders that failed the ASD went on to further surgical treatment. Average follow-up was 56 months (range, 13 to 78 months). The average American Shoulder and Elbow Society score at follow-up was 90.4. No difference between Workers' Compensation cases and the other cases was seen (P <.7). Finger palpation can help to improve outcomes by allowing the surgeon to assess the adequacy of decompression.

Acromion↗
PubMed2006

CACNA1H mutations in autism spectrum disorders.

Autism spectrum disorders (ASD) are neurodevelopmental conditions characterized by impaired social interaction, communication skills, and restricted and repetitive behavior. The genetic causes for autism are largely unknown. Previous studies implicate CACNA1C (L-type Ca(V)1.2) calcium channel mutations in a disorder associated with autism (Timothy syndrome). Here, we identify missense mutations in the calcium channel gene CACNA1H (T-type Ca(V)3.2) in 6 of 461 individuals with ASD. These mutations are located in conserved and functionally relevant domains and are absent in 480 ethnically matched controls (p = 0.014, Fisher's exact test). Non-segregation within the pedigrees between the mutations and the ASD phenotype clearly suggest that the mutations alone are not responsible for the condition. However, functional analysis shows that all these mutations significantly reduce Ca(V)3.2 channel activity and thus could affect neuronal function and potentially brain development. We conclude that the identified mutations could contribute to the development of the ASD phenotype.

Autistic Disorder↗
PubMed2003

Bone marrow findings in patients with adult Still's disease.

OBJECTIVE: Peripheral neutrophilia is one of characteristic laboratory findings in patients with adult Still's disease (ASD). We performed this study to identify the bone marrow findings in patients ASD. METHODS: We examined 12 bone marrow biopsy specimens from patients with ASD. RESULTS: The most frequent finding was granulocyte hyperplasia (12/12, 100%) and hypercellularity was observed in 75.0% (8/12) of patients. Plasmacytosis was present in 8.3% (1/12) of specimens. Histiocytosis and reactive hemophagocytosis were found in 25.0% (4/12) and in 16.7% (2/12) respectively. CONCLUSION: Our results show that bone marrow granulocyte hyperplasia is the main possible mechanism for peripheral neutrophilia and that histiocytic activation is a not infrequent bone marrow findings in patients with ASD.

Adolescent↗
PubMed2006

Autism and attention deficit hyperactivity disorder: assessing attention and response control with the integrated visual and auditory continuous performance test.

Symptoms of attention deficit hyperactivity disorder (ADHD) have been widely reported in children with autism spectrum disorder (ASD). The current study investigated attention and response control in children with ASD, ADHD, and typical development using the Integrated Visual and Auditory Continuous Performance Test. Results indicate that many children with ASD show significant deficits in visual and auditory attention and greater deficits in impulsivity than children with ADHD or typical development. These findings suggest that many of the children with ASD demonstrate significant ADHD-like deficits. These findings are discussed in the context of symptoms, subtypes, and comorbidity.

Analysis of Variance↗
PubMed2006

Visual scanning and pupillary responses in young children with Autism Spectrum Disorder.

Using eye-tracking technology we investigated visual scanning and pupillary responses to face and non-face stimuli in nine children (M = 49.6 months) with Autism Spectrum Disorder (ASD) compared to six mental-age and nine chronological-age matched children. The results revealed a significant decrease in visual scanning to landscapes. In addition, the ASD group showed pupillary constriction to children's faces, while control groups showed pupillary dilation. Visual scanning responses to landscapes had a negative correlation with the Behavior subscale of the Autism Diagnostic Observation Schedule-Generic for the ASD group. Potential use of these measures as early indicators of ASD is discussed.

Autistic Disorder↗
PubMed2002

Use of an artificial neural network to differentiate between ECGs with IRBBB patterns of atrial septal defect and healthy subjects.

Atrial septal defect (ASD) is one of the most commonly recognized congenital cardiac anomalies in adults, but its diagnosis is easily missed because about half of the patients are asymptomatic early in life. Although an electrocardiogram (ECC) diagnosis with an incomplete right bundle branch block (IRBBB) pattern is of major importance for this disease, an RSR' complex similar to an IRBBB pattern is also found in some healthy individuals. A feed-forward artificial neural network was constructed to distinguish between ASD and healthy subjects using 12-lead ECGs with IRBBB. A total of 106 clinically validated subjects, including 58 with ASD and 48 healthy subjects were used in this study. QRS and T wave measurements from I, II, and all precordial leads were used as the input parameters to a back propagation network. The leave-one-out method revealed that in the test data (106 cases), the overall accuracy, sensitivity and specificity of the artificial neural network were 91.5, 91.4, and 91.7%, respectively. This study demonstrates that the neural network technique may offer higher accuracy than computerized ECG diagnosis of IRBBB from the viewpoint of ASD.

Bundle-Branch Block↗
PubMed2005

Support for the homeobox transcription factor gene ENGRAILED 2 as an autism spectrum disorder susceptibility locus.

Our previous research involving 167 nuclear families from the Autism Genetic Resource Exchange (AGRE) demonstrated that two intronic SNPs, rs1861972 and rs1861973, in the homeodomain transcription factor gene ENGRAILED 2 (EN2) are significantly associated with autism spectrum disorder (ASD). In this study, significant replication of association for rs1861972 and rs1861973 is reported for two additional data sets: an independent set of 222 AGRE families (rs1861972-rs1861973 haplotype, P=.0016) and a separate sample of 129 National Institutes of Mental Health families (rs1861972-rs1861973 haplotype, P=.0431). Association analysis of the haplotype in the combined sample of both AGRE data sets (389 families) produced a P value of .0000033, whereas combining all three data sets (518 families) produced a P value of .00000035. Population-attributable risk calculations for the associated haplotype, performed using the entire sample of 518 families, determined that the risk allele contributes to as many as 40% of ASD cases in the general population. Linkage disequilibrium (LD) mapping with the use of polymorphisms distributed throughout the gene has shown that only intronic SNPs are in strong LD with rs1861972 and rs1861973. Resequencing and association analysis of all intronic SNPs have identified alleles associated with ASD, which makes them candidates for future functional analysis. Finally, to begin defining the function of EN2 during development, mouse En2 was ectopically expressed in cortical precursors. Fewer En2-transfected cells than controls displayed a differentiated phenotype. Together, these data provide further genetic evidence that EN2 might act as an ASD susceptibility locus, and they suggest that a risk allele that perturbs the spatial/temporal expression of EN2 could significantly alter normal brain development.

Autistic Disorder↗
PubMed2002

AIDS-related primary brain lymphoma in Michigan, January 1990 to December 2000.

To examine the effect of highly active antiretroviral therapy (HAART) on the occurrence of primary brain lymphoma (PBL), determine the risk factors for PBL, and assess the difference in survival between individuals who did and did not develop PBL, data were analyzed from the Michigan Adult/Adolescent Spectrum of HIV Disease project (ASD). Among 4,026 HIV-infected individuals enrolled in ASD between January 1990 and December 2000, 64 (1.6%) were diagnosed with PBL. The incidence rate of PBL declined from 5.6 cases per 1000 person-year in the pre-HAART era to 2.1 cases per 1000 person-year in post-HAART era. In the multivariate analysis, individuals whose CD4 count at entry in ASD was either <50 cells/microL (OR: 5.0) or 50-200 cells/microL (OR: 2.3) were significantly more likely to develop PBL than those with a CD4 count >/= 200 cells/microL. PBL was a terminal condition in these patients. The median survival time was consistently shorter among individuals who developed PBL than those who did not, regardless of their CD4 count at entry into ASD.

Adult↗
PubMed1997

Induction of mucosal and systemic responses against human immunodeficiency virus type 1 glycoprotein 120 in mice after oral immunization with a single dose of a Salmonella-HIV vector.

Previous studies from our group showed that a Salmonella-HIV vector vaccine that expressed recombinant HIV-1 envelope protein gp120 stably in the vector cytoplasm elicited type 1 helper T cell (Th1) responses to gp120. Despite the promise of such vaccines, a major limitation in their use was that multiple immunizations were required to elicit even small responses. For this reason, we sought a modified vector configuration that would induce more potent gp120-specific T cell responses exhibiting a broader spectrum of effector functions after a single inoculation. In this article we describe the construction and immunogenicity of a Salmonella-HIV vector that displays a truncated derivative of HIV-1(IIIB) envelope in the periplasm of the vector. A single oral dose of this Salmonella vector, called H683(pW58-asd+), generated a gp120-specific proliferation response in the spleen 14 days after immunization. In agreement with our previous findings, the gp120-specific splenic CD4+ T cells elicited by H683(pW58-asd+) displayed a Th1 phenotype; however, gp120-specific splenic CD4+ Th2 cells were also evident. In addition, this strain induced strong gp120-specific IgA antibody-secreting cell (ASC) responses in the intestinal lamina propria and mesenteric lymph nodes. As many as 2% of the total lamina propria and mesenteric lymph node IgA ASCs were found to be specific for gp120 28 days after a single oral dose of H683(pW57-asd+). Because the proliferative response following a single dose of H683(pW58-asd+) was comparable to that seen previously after three doses of an analogous construct expressing recombinant gp120 in the cytoplasm, these observations suggest that Salmonella-vectored secreted HIV-1 antigens elicit higher T cell responses than their cytoplasmically bound analogs.

Administration, Oral↗
PubMed2006

Attention-deficit hyperactivity disorder symptoms in a clinic sample of children and adolescents with pervasive developmental disorders.

OBJECTIVES: The aims of this systematic chart review were to determine the frequency of attention-deficit/hyperactivity disorder (ADHD) in a clinic sample of children and adolescents with autism spectrum disorders (ASD), to compare ADHD symptoms in children with Autistic Disorder, Asperger's Disorder, and pervasive developmental disorders-not otherwise specified (PDD-NOS), to compare ADHD symptoms in individuals with and without ADHD-related chief complaints, and to determine the correlation between ADHD Rating Scale (ADHD RS) scores and age. METHOD: This systematic chart review examined data from children and adolescents who were consecutively referred to a university-based autism psychopharmacology program. All individuals were diagnosed by semistructured interview for ASD and ADHD, and ADHD symptoms were assessed using ADHD RS scores. RESULTS: Of 83 children, 78% fulfilled Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for ADHD and exceeded the 93rd percentile norm for the ADHD RS. Hyperactivity-impulsivity scores were significantly greater in individuals with autism than those with other ASDs. DSM-IV ADHD diagnosis was represented equally in individuals with and without ADHD as their chief complaints. ADHD RS hyperactivity-impulsivity and total scores were negatively correlated with age. CONCLUSION: ADHD symptoms are pervasive in clinically referred children and adolescents with ASD.

Adolescent↗
PubMed2005

Anatomical differences in the mirror neuron system and social cognition network in autism.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with impaired social and emotional skills, the anatomical substrate of which is still unknown. In this study, we compared a group of 14 high-functioning ASD adults with a group of controls matched for sex, age, intelligence quotient, and handedness. We used an automated technique of analysis that accurately measures the thickness of the cerebral cortex and generates cross-subject statistics in a coordinate system based on cortical anatomy. We found local decreases of gray matter in the ASD group in areas belonging to the mirror neuron system (MNS), argued to be the basis of empathic behavior. Cortical thinning of the MNS was correlated with ASD symptom severity. Cortical thinning was also observed in areas involved in emotion recognition and social cognition. These findings suggest that the social and emotional deficits characteristic of autism may reflect abnormal thinning of the MNS and the broader network of cortical areas subserving social cognition.

Adult↗
PubMed2005

Analysis of educational support systems for children with mental retardation and autism spectrum disorders.

Children with autism spectrum disorders (ASDs) have the right to education. In India, ASDs are covered by the National Trust Act, which focuses on guardianship. Education is predominantly provided by non-government organizations and varied models are used in educating the children. This study aimed to compile information on the current educational models and to find out the feasibility for replication. The major models found to be in use were: special schools, inclusive schools, home-based instruction and units established by parent groups. The choice of model depended on the child's level of functioning and parental aspirations. About 46.8% preferred home-based instruction, while 25.8% were enrolled in special schools and 19.4% were in inclusive schools. All children initially needed home-based training. Picture activity schedules, discrete trial training, sensory integration and structured environment were found to be effective in the education of children with ASDs. Although children improved with home-based instruction, parents expressed stress. About 73% of the parents were eager to send their children to a suitable school, but dissatisfied with the existing facilities. Recognizing ASDs as a disability in the Persons with Disabilities Act (1995) will strengthen and promote the education of children with these conditions.

Adolescent↗
PubMed1997

Interventional atrioseptostomy by application of monopolar high-frequency alternating current. In vitro evaluation of a new device.

RATIONALE AND OBJECTIVES: The authors evaluate the use of a new device for interventional creation of atrial septal defects (ASD) working with high-frequency alternating current in an in vitro study with porcine atria. METHODS: The device consists of a symmetrical cage of six superelastic monofile wires, including a microthermistor that is placed via a catheter into a punctured hole in the porcine foramen ovale. The device is used as a differential electrode for monopolar, temperature-controlled application of high-frequency alternating current for thermal modelling of ASD. RESULTS: Application of current for 60 seconds caused temperature-dependent, sized ASDs. CONCLUSION: In vivo animal studies to evaluate possible side effects and long term patency of the ASDs are justified and warranted.

Animals↗
PubMed2006

Parental perceptions and use of complementary and alternative medicine practices for children with autistic spectrum disorders in private practice.

The prevalence of autistic spectrum disorder (ASD) in the United States is approximately 1 in 150 children. Many health care providers are unaware of parental beliefs and treatments, both medical and complementary, that parents use for their child with ASD. Understanding these beliefs and practices concerning diagnosis, cause, and utilization of medical and complementary care may help physicians provide better comprehensive care. Parents of children with ASD from 2 private practices-one in New York and one in New Jersey-were mailed a 6-page, self-administered survey. In addition to demographics and ASD type, the survey asked parents who diagnosed their child and if there was a perceived delay in that diagnosis; whether they believed there was any causal reason for their child's autism; what chronic symptoms, if any, their child experiences; and, if they had used any complementary and/or alternative therapies and at whose recommendation. Respondents included 77 of the 150 parents (51%) contacted. Most children were diagnosed by a neurologist and/or developmental pediatrician (54% and 47%, respectively). Average perceived delay in diagnosis was 18 months. Parents most frequently cited immunizations (54%), genetic predisposition (53%), and environmental exposure (38%) as a cause of their child's autism. Approximately half of children were reported as having at least one gastrointestinal, neurological, and/or allergic symptom; more than a third had immunological symptoms. Almost all parents (95%) indicated some use of complementary and alternative medicine (CAM) therapies, with most of the self-reported referrals generated from a physician or nurse (44%). Systemic complaints, parental beliefs, and use of CAM practices warrant open discussion by all health care professionals who provide care to this population.

Asperger Syndrome↗
PubMed2006

Diagnostic yield in the clinical genetic evaluation of autism spectrum disorders.

PURPOSE: Clinical geneticists are often asked to evaluate patients with autism spectrum disorders (ASDs) in reference to questions about cause and recurrence risk. Recent advances in diagnostic testing technology have greatly increased the options available to them. It is not currently clear what the overall diagnostic yield of a battery of tests, either collectively or individually, might be. The purpose of this study was to evaluate the diagnostic yield of a stepwise approach we have implemented in our clinics. METHODS: We used a three-tiered neurogenetic evaluation scheme designed to determine the cause of ASDs in patients referred for clinical genetic consultation. We reviewed the results of our diagnostic evaluations on all patients referred with a confirmed diagnosis of autism over a 3-year period. RESULTS: By using this approach, we found an overall diagnostic yield for ASDs of more than 40%. This represents a significant increase in the diagnostic yield reported just a few years ago. CONCLUSIONS: Given the implications of these diagnoses on recurrence risk and associated medical conditions, a targeted neurogenetic evaluation of all persons with ASDs seems warranted. We discuss the issues in the future implementation of a fourth tier to the evaluation with the potential for an even higher diagnostic yield.

Autistic Disorder↗
PubMed2004

The relationship of attribution of responsibility to acute stress disorder among hospitalized burn patients.

Attribution of responsibility for a traumatic event has been related to subsequent adjustment. Self-blame has been associated with better adjustment in some cases and worse in others, whereas other-blame has consistently been associated with poorer outcomes. This study assessed the relationship between attribution of responsibility and acute stress disorder (ASD) in burn victims. Hospitalized burn patients (N = 124) underwent psychological assessment within 2 weeks of their burn injury. Participants were categorized as reporting self-blame (N = 49), other-blame (N = 36), both (N = 10), or neither (N = 29). Twenty-three percent of those with other-blame were diagnosed with ASD, compared with 0% of those with self-blame. Self-blame and other-blame also were related to ASD in logistic regression analyses controlling for demographic and medical variables. With both types of blame in the same model, self-blame was significantly associated with lower rates of ASD, whereas other-blame was related to higher rates, but this did not reach significance. When analyzed in separate models, both of these relationships attained statistical significance. These findings have implications for identifying and treating people at risk for posttraumatic stress disorder after exposure to trauma.

Adolescent↗
PubMedDate not supplied

Repressive coping style, acute stress disorder, and posttraumatic stress disorder after myocardial infarction.

OBJECTIVE: The study examined the associations between repressive coping style, acute stress disorder (ASD) and subsequent posttraumatic stress disorder (PTSD) after myocardial infarction (MI) to ascertain the efficacy of repressive coping style in immediate and long-term adjustment to stress. METHODS: A total of 116 MI patients were examined twice: within a week of their MI (time 1) and 7 months later (time 2). At time 1, repressive coping style, perceived threat, and ASD were measured by self-report questionnaires. In addition, medical measures indicative of the severity of the MI were obtained from patients' hospital records. At time 2, PTSD was assessed. The distribution of the repressive coping style was compared with that of 72 matched control subjects. RESULTS: Findings revealed the adaptiveness of repressive coping style both in the immediate and longer-term aftermath of MI: repressors endorsed less ASD and PTSD than nonrepressors. In addition, the contribution of repressive coping style to PTSD was unique and beyond the implications of severity of MI, perceived threat, and immediate ASD. CONCLUSIONS: The findings support the role of repressive coping style as a stress-buffer; several mechanisms that explain this role are suggested.

Adaptation, Psychological↗