Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ASD”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,297 records · Page 72Linked to original sources
PubMed1999

Continuous transesophageal echocardiographic (TEE) monitoring during port-access cardiac surgery.

BACKGROUND: Since the introduction of the closed-chest minimally invasive heart surgery using the Port-Access system a variety of monitoring techniques including fluoroscopy, transesophageal echocardiography (TEE) and invasive pressure measurements have been described. We investigated whether or not single TEE is feasible for perioperative monitoring of the placement, localization and proper function of the endovascular cardiopulmonary bypass (CPB) devices. METHODS: Fifty-one patients (35 mitral valve repair or replacement [MVR], 8 coronary artery bypass grafting [CABG], 5 atrial septal defects [ASD] and 3 left atrial myxoma) were subjected to Port-Access surgery (PAS). Intraoperative Omniplane-TEE (2D- and color-flow Doppler techniques) was used as the leading monitoring device for correct positioning of the endopulmonary vent catheter and the venous cannula, and for the visualization of the guide wire and the endoaortic occlusion catheter (Endoclamp). After balloon inflation, its proper positioning and function during endo-aortic occlusion, sufficient delivery of cardioplegia into the coronary ostia, absence of leakage flow and adequate venting were controlled. Left and right radial artery catheters as well as aortic root pressure measurements served as controls. Additional fluoroscopy was used as standby device. RESULTS: In 46 patients (90.1%) sufficient perioperative monitoring was provided by single TEE. In five cases additional intermittent fluoroscopy was necessary for correct positioning of the guide wire (CABG) and the Endoclamp (three MVR and one ASD). Dislocation of the Endoclamp into the left ventricle was observed once but was successfully corrected by TEE guidance. Weaning from CPB and de-airing were easily guided with TEE. We did not observe balloon-mediated aortic injury or aortic valve dysfunction, and myocardial recovery from CPB was uneventful. All cases of MVRs showed sufficient results (68% without evidence of regurgitation, 32% showed residual mitral valve incompetence of less than grade II). Neither perivalvular leakage (MV-replacement) nor shunt- (residual ASD) flow were detectable. CONCLUSIONS: We recommend single TEE as a safe and effective on-line imaging device for monitoring the endovascular CPB system during PAS. Fluoroscopy with its potential risk for the patients and the staff due to x-ray exposure should only be used in the presence of peripheral vascular disease or when echocardiographic imaging is insufficient.

Cardiopulmonary Bypass↗
PubMed1975

[Dermatologlyphic investigations in a kindred manifesting familial atrial septal defect (ostium secundum). A contribution to the problem of genetic counselling in multifactorial inheritance (author's transl)].

In order to improve the possibilities of genetic counselling in multifactorial inheritance, dermatoglyphic investigations were performed in a family with atrial septal defect (ostium secundum) - ASD II - affecting two out of six children of a married couple and a maternal aunt. The frequency of finger-print patterns differed widely between the husband and his father on the one hand and the wife and her relatives on the other hand. Assuming some partial effect of the ASD II genes on the total gene influence on dermatoglyphics, it seemed possible that the finger-prints of the two affected siblings and of those brothers who were fairly near the threshold of ASD manifestation might resemble more closely the finger-prints of their mother and their mother's relatives than the finger-prints of their father and their paternal grandfather. This assumption was, however, disproven.

Chromosomes↗
PubMedDate not supplied

Infliximab in the treatment of adult Still's disease refractory to conventional therapy.

In this study we evaluated the efficacy of Infliximab in the treatment of adult Still's disease (ASD) refractory to conventional therapy. Three patients with chronic and active ASD unresponsive to corticosteroids and methotrexate were given intravenous Infliximab infusions at a dosage of 3 mg/kg at weeks 0, 2, 6 and then once every 8 weeks. Methotrexate was maintained in all cases at a dosage of 15 mg/week, whereas the prednisone dose was modified according to disease activity. The follow-up lasted 50 weeks and disease activity improved in all cases during Infliximab therapy. Two patients presented arthralgias and sore throat at 20 and 28 weeks, that was rapidly controlled by Infliximab reinfusion every 4 weeks. One patient relapsed at 18 weeks and dropped out at 22 weeks due to an urticarioid rash after the beginning of the fifth infusion. Infliximab may be effective in the treatment of relapse of ASD refractory to conventional therapy and requiring continuous high dose corticosteroid medication. Further studies are needed to evaluate the long-term safety, efficacy and the optimal schedule of infusion.

Adult↗
PubMed2001

Do not underestimate atrial septal defect!

Atrial septal defect (ASD) is one of the simplest cases among the surgically correctable congenital cardiac diseases. Easiness of the correction usually causes underestimation of the pathology. Angiography as well as echocardiography might be misleading in some cases. The preliminary diagnosis of the presented case was secundum ASD. During operation an unusual type of partial anomalous pulmonary venous connection (PAPVC) was noticed. Pulmonary veins of the entire left lung were draining to the right atrium directly. There was no other coexisting cardiac pathology including atrial septal defect. To our knowledge, there is no similar case in the literature. ASD is a well known congenital cardiac disease. Coexisting anomalies increase the surgical importance of the defect. Cardiologists should suspect and search for even the rarest pathologies during preoperative evaluation to prevent diagnostic misinterpretations and surgical surprises. Trying to explore the relations of cardiac chambers and define the pathology during extracorporeal circulation is time consuming. Despite this, a routine and meticulous exploration should not be neglected to prevent unexpected results.

Abnormalities, Multiple↗
PubMed2001

Autistic spectrum disorders in preschool children.

OBJECTIVE: To review existing data on early signs of autistic spectrum disorders (ASD) and on how these disorders can be distinguished from other atypical patterns of development, and to describe a developmental surveillance approach that family physicians can use to ensure that children with these diagnoses are detected as early as possible. QUALITY OF EVIDENCE: MEDLINE was searched from January 1966 to July 2000 using the MeSH terms autistic disorder/diagnosis AND diagnosis, differential AND (infant OR child, preschool). Articles were selected based on relevance to developmental surveillance in primary care and on experimental design, with emphasis on prospective studies with systematic measurement procedures using up-to-date diagnostic criteria. MAIN MESSAGE: Autistic spectrum disorders are characterized by impairments in social interaction and verbal and nonverbal communication, and by preferences for repetitive interests and behaviours. Early signs that distinguish ASD from other atypical patterns of development include poor use of eye gaze, lack of gestures to direct other people's attention (particularly to show things of interest), diminished social responsiveness, and lack of age-appropriate play with toys (especially imaginative use of toys). Careful attention to parents' concerns and specific inquiry into and observation of how children interact, communicate, and play will help ensure that early signs are detected during regular health maintenance visits. CONCLUSION: Family physicians have an important role in early identification of children with ASD. Early diagnosis of these disorders is essential to ensure timely access to interventions known to improve outcomes for these children.

Autistic Disorder↗
PubMed2000

Transcatheter closure of secundum atrial septal defects using Amplatzer device.

OBJECTIVE: To evaluate the feasibility and short term results of transcatheter closure of secundum atrial septal defects (TCSASDs) using Amplatzer occluder device. A new self-centering device, the Amplatzer atrial septal occluder, has recently been evaluated in an animal model with excellent results. This paper reports our clinical research with this device. METHODS: 30 patients underwent an attempt at TCSASDs at an average age of 35.6 +/- 15.9 y (range, 5-62 y) and average weight of 63.6 +/- 14.5 kg (range, 17-78 kg) using the Amplatzer atrial septal occluder. The average ASD diameter measured by transesophageal echocardiography (TEE) was 23.6 +/- 4.0 mm (range, 16-31 mm), and the average atrial septal defects (ASD) balloon stretched diameter was 25.2 +/- 5.8 mm (range, 9-34 mm). All patients had right atrial and ventricular volume overload with a Qp/Qs of 3.4 +/- 1.2 (1.4-5.2). A F8-12 catheter was used for delivery of the device in all patients. RESULTS: The device was placed correctly in all patients. There was immediate and complete closure in 30 patients. The average device waist size used to close the defect was 25.6 +/- 5.9 mm (range, 9-34 mm). There was no episode of device embolization or any other complication. Follow-up was performed using transthoracic echocardiography (TTE) 1 day, 1 month, 3 months, 6 months and 1 year after the procedure. The first day after operation; there was complete closure of the ASD in all patients; there have been no episodes of endocarditis, thromboembolism, or wire fracture. CONCLUSION: TCSASDs using the Amplatzer occluder device was an efficient nonsurgical method which had a very high technical success rate and satisfactory short term and follow-up results.

Adult↗
PubMed2002

[Studies on the prognostic factors of idiopathic acute sensorineural deafness].

Acute sensorineural deafness(ASD) presents with various hearing types, and dizziness and tinnitus are accompanied in some cases. The purpose of this study was to estimate the influence of risk factors, including dizziness and tinnitus, on the recovery of hearing acuity. Eighty-three patients who visited our hospital within 1 month from its onset and who were diagnosed with ASD between October 1998 and September 1999 were retrospectively reviewed. The patients whose etiology was defined, or whose symptoms shifted to inconsistent deafness were excluded. There were 35 males(ages ranged from 22 to 71 years; average 49 years) and 48 females(ages ranged from 17 to 79 years; average 46 years). The improvement rates were analysed using the following factors such as levels and hearing types at initial examination, interval between its onset and treatment, and presence or absence of dizziness and tinnitus. Concerning hearing types at initial examination, tan type or low sound disturbance type resulted in favorable prognosis. The patients whose treatment was started by the 7th day from its onset had significantly better prognosis than those whose treatment begun after 15 days. The patients who were complicated with tinnitus, especially accompanied with dizziness, indicated a significantly worse prognosis than those without tinnitus. Tan type or low sound disturbance type is a favorable factor, and tinnitus is an unfavorable factor for ASD prognosis. Though tinnitus generally is a significant factor for poor prognosis, this study remains to suggest that it alone causes the poor prognosis. The sooner treatment is provided indicates the better outcome.

Acute Disease↗
PubMed2002

[Disorders related to traumatic events. Screening and treatment].

OBJECTIVE: To educate family physicians about screening, diagnosis, and treatment of psychological disorders related to traumatic events. QUALITY OF EVIDENCE: PsycLIT, PsychINFO, PILOTS, and MEDLINE databases were searched from January 1985 to December 2000 using the terms "acute stress disorder," "posttraumatic stress disorder," "traumatic stress," "psychotherapy," "psychosocial treatment," "treatment," and "pharmacotherapy." Recommendations concerning treatment of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are based on evidence from trials of the highest quality. Conclusions about assessment and diagnosis are based on the most recent epidemiologic studies, consensus, and expert opinion. MAIN MESSAGE: Very often, ASD and PTSD are underdiagnosed and undertreated. Family physicians are likely to see patients suffering from these disorders. Early screening in primary care is a function of active listening; warm, safe patient-physician relationships; and careful examination of difficulties related to traumatic events. Ideally, patients with either ASD or PTSD should be referred to a specialist. If a specialist is unavailable, family physicians can offer support and prescribe medication to address patients' symptoms. CONCLUSION: Family physicians can help identify and treat patients presenting with disorders related to traumatic events.

Anti-Anxiety Agents↗
PubMed2002

[Perforation of the aorta after percutaneous closure of an atrial septal defect with an Amplatz prosthesis, presenting with acute severe hemolysis].

We report a case of aortic perforation three weeks after transcatheter occlusion of an atrial septal defect (ASD) by an Amplatzer device. Revealed by acute hemolysis, this complication needed an emergency surgical operation. The fistula between the no coronary Valsalva sinus of the aorta and the left atrium was repaired. The ASD was closed by patch. This serious accident should consider a short antero-superior rim as a risk factor for aortic perforation in transcatheter closure for ASD.

Acute Disease↗
PubMed2002

Autism, an extreme challenge to integrative medicine. Part 2: medical management.

Autism and allied autistic spectrum disorders (ASD) present myriad behavioral, clinical, and biochemical abnormalities. Parental participation, advanced testing protocols, and eclectic treatment strategies have driven progress toward cure. Behavioral modification and structured education are beneficial but insufficient. Dietary restrictions, including removal of milk and other casein dairy products, wheat and other gluten sources, sugar, chocolate, preservatives, and food coloring are beneficial and prerequisite to benefit from other interventions. Individualized IgG or IgE testing can identify other troublesome foods but not non-immune mediated food sensitivities. Gastrointestinal improvement rests on controlling Candida and other parasites, and using probiotic bacteria and nutrients to correct dysbiosis and decrease gut permeability. Detoxification of mercury and other heavy metals by DMSA/DMPS chelation can have marked benefit. Documented sulfoxidation-sulfation inadequacies call for sulfur-sulfhydryl repletion and other liver p450 support. Many nutrient supplements are beneficial and well tolerated, including dimethylglycine (DMG) and a combination of pyridoxine (vitamin B6) and magnesium, both of which benefit roughly half of ASD cases. Vitamins A, B3, C, and folic acid; the minerals calcium and zinc; cod liver oil; and digestive enzymes, all offer benefit. Secretin, a triggering factor for digestion, is presently under investigation. Immune therapies (pentoxifyllin, intravenous immunoglobulin, transfer factor, and colostrum) benefit selected cases. Long-chain omega-3 fatty acids offer great promise. Current pharmaceuticals fail to benefit the primary symptoms and can have marked adverse effects. Individualized, in-depth clinical and laboratory assessments and integrative parent-physician-scientist cooperation are the keys to successful ASD management.

Amino Acids↗
PubMed2003

Serum levels of pregnenolone and 17-hydroxypregnenolone in patients with rheumatoid arthritis and systemic lupus erythematosus: relation to other adrenal hormones.

OBJECTIVE: In patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), low levels of adrenal steroids have been repeatedly demonstrated, but the site of alteration has not been exactly described because measurements of serum pregnenolone and 17-hydroxypregnenolone (17OHPreg) together with other adrenal steroids have never been performed. METHODS: We measured serum levels of adrenal hormones such as pregnenolone, 17OHPreg, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), progesterone (P), 17-hydroxyprogesterone (17OHP), androstenedione (ASD), and cortisol in 24 healthy controls, 24 patients with RA, and 24 patients with SLE. RESULTS: Serum levels of pregnenolone were similar in RA and SLE patients as compared to healthy controls irrespective of prior prednisolone therapy. In all RA and SLE patients (including those with prior prednisolone treatment), serum levels of all measured hormones except pregnenolone were significantly lower as compared to controls. In RA patients without prior prednisolone treatment, serum levels of 17OHPreg, DHEA, cortisol, and ASD were similar to controls, and serum levels of P, 17OHP, and DHEAS were significantly lower as compared to controls. In SLE patients without prior prednisolone treatment, serum levels of 17OHPreg and cortisol were similar, and serum levels of P, 17OHP, ASD, DHEA, and DHEAS were significantly lower as compared to controls. CONCLUSION: The primary hormone of the adrenal steroid cascade, pregnenolone, is almost normal in RA and SLE irrespective of corticosteroid treatment. In patients with RA, we believe that there is a near normal P450scc reaction and a normal double step P450c17 reaction. In SLE patients, the P450scc reaction also seems normal but the second step of the P450c17 reaction seems to be inhibited. In both diseases, cortisol levels remain relatively stable at the expense of other adrenal hormones. This study revealed distinct changes of steroid pathways that are related to the disease entities.

17-alpha-Hydroxypregnenolone↗
PubMed2003

[Autism and hyperlexia].

INTRODUCTION: Hyperlexia is described in children who present alterations or retardation in development and is frequently characterised by their teaching themselves to read at an early age. This ability to decode words does not correlate with their intellectual level and can course with different degrees of mental retardation. It is always accompanied by difficulty in establishing social relationships. Autism is a disorder that is prototypical of the autistic spectrum disorders (ASD), which are essentially characterised by qualitative alterations in social interaction, in communication and language development, and in the presence of a limited repertory of interests, accompanied by stereotyped or peculiar responses. METHOD: The presence of hyperlexia in autistic children is more frequent than in other development disorders. This phenomenon is linked with the increased skills involving visual memory, visual discrimination and motivation/interest towards visually represented material that is to be found in people with autism. However, not all autistic individuals present hyperlexia and not all children with hyperlexia present autism, although evidence shows that hyperlexia is a phenomenon that is observed with greater frequency in autism and in ASD. CONCLUSION: Hyperlexia, understood as meaning a little island of ability in children with autism and ASD, poses a number of questions and represents an important challenge in neuropsychological research in this population.

Age Factors↗
PubMed2003

Transcatheter closure of atrial septal defects.

Until recently, surgical repair was the standard treatment for an ostium secundum atrial septal defect (ASD), a common congenital heart defect. Closing ASDs using a device inserted via a catheter now offers another option for some patients. Limited comparative data indicate that newer approaches to transcatheter repair have a higher failure rate than that for surgery, but short-term complication rates are lower. Evidence from long-term follow-up of patients with device closure of ASDs is not yet available. Equipment and procedure costs may be higher for transcatheter closure than for surgery, but overall costs may be reduced through avoiding intensive care unit costs and through shorter hospital stays.

Canada↗
PubMed2003

[Atrial septal defect and transesophageal echocardiography. From the diagnosis to the monitoring of transcatheter closure].

Atrial septal defect (ASD) is a common congenital heart disease representing 30% of congenital lesions in adults. Transcatheter closure has been regarded as an acceptable alternative treatment for patients with ASD. The prevalence of patent oval foramen (POF) is approximately 26% in autopsy and clinical studies, but it has been demonstrated that this prevalence is higher in patients with cryptogenic stroke. Even though the role of POF in the etiopathogenesis of cryptogenic stroke is debated, recurrent paradoxical embolism in the presence of POF associated with high motility of the membrane or with an atrial septal aneurysm is currently considered an indication for POF closure. This review covers the role of echocardiography (including transthoracic, transoesophageal and 3-dimensional methods) in the detection and diagnosis of these defects as well as the contribution of these techniques in the monitoring and follow-up of ASD and POF percutaneous closure.

Cardiac Catheterization↗
PubMed2004

Atrial septal defect repair with minithoracotomy using two stage single venous cannula.

AIM: Repair of atrial septal defect (ASD) via minimal access has been the preferred method to improve cosmesis and fast rehabilitation. A 2-stage single venous cannula introduced via the femoral route allows better vision of the surgical field and improves surgical acts through a limited incision. METHODS: From February 1999 to December 2001 a minithoracotomy approach was used for closure of secundum type ASD by using single bicaval venous cannula in 17 adult patients. A 6 to 7 cm anterior minithoracotomy (submammary) approach with femoral arterial and 2-stage single venous cannula were utilized. Defects were closed primarily by running suture in 14 and with a patch in 3 patients. RESULTS: Calculated flow levels were maintained with a single venous cannula without assisted venous drainage in all patients. The postoperative course was uneventful in all patients except 1 who required revision for bleeding which was done through the same incision. Extension of the thoracotomy or shifting to the classic sternotomy was never required. CONCLUSION: Single venous bicaval cannula allows efficient drainage of both vena cavae and improves the surgical vision and manipulation through the right minithoracotomy. With this technique, repair of ASD can be done safely with good cosmesis.

Adolescent↗
PubMed2004

[Acute stress disorder and posttraumatic stress disorder after motor vehicle accidents].

OBJECTIVE: We examined the rates of and factors associated with the development of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) after motor vehicle accidents (MVAs). METHOD: Forty hospitalized patients who had orthopedic injuries after MVAs and 26 hospitalized patients who had orthopedic injuries without a MVA were included in the study. One month after the MVA, the General Health Questionnare (GHQ) Hamilton Depression Rating Scale (HDRS), Multidimensional Scale of Perceived Social Support (MSPSS), Peritraumatic Dissociative Experiences Questionnare (PDEQ) and sociodemographic data questionnaire were given to all patients. At 3 and 6 months follow-up the Clinician Administered PTSD Scale (CAPS), HDRS, GHQ, and a questionnaire concerning medical problems caused by the accident along with economic and legal problems were applied. RESULTS: 20% of the inpatients in the MVA group developed ASD in the 1st month, 30% developed PTSD in the 3rd month and 17% developed PTSD in the 6th month, while in the control group none of the patients developed either ASD or PTSD. The MVA group had higher mean GHQ, HDRS and CAPS scores than the controls at the 1st, 3rd and the 6th months of follow-up. CONCLUSION: Serious and long-term psychiatric problems are seen after MVAs. Early intervention and rehabilitation are needed for the risk groups determined.

Accidents, Traffic↗
PubMed2004

Transcatheter closure of secundum atrial septal defects with complex anatomy.

The aim of this study was to evaluate the feasibility, safety and efficacy of transcatheter closure of secundum atrial septal defects (ASD) in patients with complex anatomy. From September 1997 to July 2003, a total of 40 patients (median age, 34 years; 65% female) with complex ASDs, defined as the presence of a large defect (stretched diameter >26 mm) associated with a deficient rim (n=23); multiple defects (n=8); a multi-fenestrated septum (n=5); and defects associated with an aneurysmal septum irrespective of their size (n=4) underwent closure. The Helex device was used in 4 patients and the Amplatzer in the remaining. Two devices were implanted in 2 patients each. Implantation was unsuccessful in 5 patients, with 4 having large defects associated with a deficient anterior rim and a floppy posterior septum. Occlusion was observed in 22 of 35 patients (63%) immediately after implantation and in 31 (89%) at a mean follow-up of 18+/-9 months. No major complications occurred. Right ventricular end-diastolic dimensions (indexed for body surface area) decreased from 135+/-25% before closure to 124+/-15% 24 hours after closure, and to 92+/-12% after 12 months. Two patients with 2 distant defects and 2 patients with large defects remained with shunts (<4 mm) at the latest visit. Transcatheter closure of complex secundum ASDs was feasible, safe and effective; however, large defects associated with a deficient anterior rim and a floppy posterior septum may not be suitable for this approach.

Adult↗
PubMed2004

[Assessment of atrial pathologies in children using transesophageal echocardiography].

OBJECTIVE: Transesophageal echocardiography (TEE) is indicated for suspected atrial septal pathology and for monitoring of interventional procedures such as an atrial septal defect (ASD) closure during cardiac catheterization. Transesophageal echocardiography also helps to demonstrate postoperative complications and residual defects of complex congenital cardiac anomalies. METHODS: Transesophageal echocardiography was performed in 112 pediatric patients with or suspected atrial pathology at our institution between 1999-2002, using the standard techniques. The mean age was 8.7+/-4.2 years. RESULTS: In 45 of 112 children the suspected atrial defects were confirmed with the TEE. Patent foramen ovale was correctly predicted in 13.4% of patients by TEE, but only in 8.7% of patients by echocardiography. Multiple ASD's were correctly defined in 4.1%, and high venosus defects were documented in 6.1% of children by the TEE. We used TEE in 13% of patients for detecting atrial vegetations in patients with possible endocarditis, and evaluation of the postoperative care of atrial surgery such as Fontan or Senning operations and total correction of abnormal pulmonary venous return. Successful transcatheter closure of 7 ASD's was accomplished under TEE guidance. CONCLUSION: Transesophageal echocardiography allows a much more detailed evaluation of atrial morphology than transthoracic echocardiography even in infants. Transesophageal echocardiography is also indicated during interventional procedures and postoperative evaluation of the atrial pathology.

Adolescent↗