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ASD
Terms modified by ASD Selected AbstractsRight Ventricular Function in Congenital Heart Defects Assessed by Regional Wall MotionCONGENITAL HEART DISEASE, Issue 3 2010FSCAI, Michael R. Nihill MB ABSTRACT Objectives., To develop a simple method to assess right ventricular function by angiography. Background., Conventional methods of evaluating right ventricular function are inaccurate, cumbersome, and expensive. Methods., We analyzed biplane right ventricular angiograms taken in the posterior,anterior and lateral projections using software to measure right ventricular volumes and regional wall motion in 78 patients with normal hearts (n = 29), atrial septal defects (ASD n = 13), pulmonary valve stenosis (PVS n = 21), and postoperative atrial switch patients (n = 15). We also measured the shortening fraction (SF) from the midtricuspid annulus to the septum and correlated various angiographic measurements with the right ventricular (RV) ejection fraction. Results., The volume-overloaded patients (ASD) had larger end diastolic volumes and increased SF compared with normal patients, while the pressure-loaded patients (PVS) had normal volumes and SF. The postoperative atrial switch patients had decreased systolic function and increased end diastolic volume. The SF for all of the patients correlated with the ejection fraction (r= 0.785, P, .0001). Conclusions., A simple measurement of the end diastolic and end systolic distance from the midtricuspid annulus to the septum (SF) provides a good index of RV function by angiography and correlates well with RV ejection fraction. [source] Transcatheter versus Surgical Closure of Secundum Atrial Septal Defect in Adults: Impact of Age at Intervention.CONGENITAL HEART DISEASE, Issue 3 2007A Concurrent Matched Comparative Study Abstract Objectives., To compare the short- and mid-term outcomes of surgical (SUR) vs. transcatheter closure of secundum atrial septal defect (ASD) using Amplatzer septal occluder (ASO) in adults with a very similar spectrum of the disease; and to identify predictors for the primary end point. Design., Single-center, concurrent comparative study. Surgically treated patients were randomly matched (2:1) by age, sex, date of procedure, ASD size, and hemodynamic profile. Setting., Tertiary referral center. Patients., One hundred sixty-two concurrent patients with ASD submitted to ASO (n = 54) or SUR closure (n = 108) according with their preferences. Main Outcome Measures., Primary end point was a composite index of major events including failure of the procedure, important bleeding, critical arrhythmias, serious infections, embolism, or any major cardiovascular intervention-related complication. Predictors of these major events were investigated. Results., Atrial septal defects were successfully closed in all patients, and there was no mortality. The primary event rate was 13.2% in ASO vs. 25.0% in SUR (P = .001). Multivariate analysis showed that higher rate of events was significantly associated with age >40 years; systemic/pulmonary output ratio <2.1; and systolic pulmonary arterial pressure >50 mm Hg; while in the ASO group the event rate was only associated with the ASD size (>15 cm2/m2; relative risk = 1.75, 95% confidence interval 1.01,8.8). There were no differences in the event-free survival curves in adults with ages <40 years. Conclusions., The efficacy for closure ASD was similar in both groups. The higher morbidity observed in SUR group was observed only in the patients submitted to the procedure with age >40 years. The length of hospital stay was shorter in the ASO group. Surgical closure is a safe and effective treatment, especially in young adults. There is certainly nothing wrong with continuing to do surgery in countries where the resources are limited. [source] Novel treatments for autistic spectrum disordersDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2005Susan E. Levy Abstract In no area of developmental pediatric practice is there more controversy regarding the choice of treatment than related to children with autistic spectrum disorders (ASD). Complementary and alternative medical therapies (CAM) are often elected because they are perceived as treating the cause of symptoms rather than the symptoms themselves. CAM used for autism can be divided by proposed mechanism: immune modulation, gastrointestinal, supplements that affect neurotransmitter function, and nonbiologic intervention. Secretin as a therapy for autism is discussed as an example of how a clinical observation rapidly grew to a widespread treatment before well-designed studies demonstrated absence of effect. The plausibility for behavioral effect was not substantiated by clinical studies. CAM used for treatment of autism is examined in terms of rationale, evidence of efficacy, side effects, and additional commentary. Families and clinicians need access to well-designed clinical evidence to assist them in choice of therapies. © 2005 Wiley-Liss, Inc. MRDD Research Reviews 2005;11:131,142. [source] Prevalence and characteristics of autistic spectrum disorders in the ALSPAC cohortDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 9 2008Emma Williams MSc PhD The aim of this study was to determine the prevalence of autistic spectrum disorder (ASD) within a large representative population sample: the Avon Longitudinal Study of Parents and Children (ALSPAC). Cases of ASD were identified from the clinical notes of children in the ALSPAC with a suspected developmental disorder and from the Pupil Level Annual Schools Census (PLASC) for England in 2003. Seventy-one cases of ASD diagnosed after a multidisciplinary assessment were identified from health records. There were an additional 15 cases from PLASC data in which ASD was mentioned as a principal difficulty, thus giving a total of 86 children diagnosed by the age of 11 years. Prevalence of ASD per 10 000 population at 11 years was 51.1 for those with a multi-professional diagnosis, and 61.9 if cases from education were included, made up of 21.6 for childhood autism, 10.8 for atypical autism, 16.6 for Asperger syndrome, and 13.0 for unspecified ASD. The male:female ratio was 6.8:1. Median age at diagnosis ranged from 45 months in childhood autism to 116 months in Asperger syndrome. A comorbid developmental disorder was recorded in 33.8% of cases, including learning disability, in 14.7%, epilepsy in 10.3%, and mixed developmental disorder in 4.4%. We conclude that the prevalence of ASD diagnosed at 11 years in a UK representative population-based sample is at least 51.1/10 000. [source] Autism spectrum disorder and underlying brain mechanism in the oculoauriculovertebral spectrumDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2007Maria Johansson MD As part of a multidisciplinary study, the rate of autism spectrum disorder (ASD), learning disability (LD), and brain abnormalities was examined in 20 participants (12 males, 8 females; age range 8mo-17y, mean age 8y 1mo) diagnosed as falling within the oculoauriculovertebral spectrum (OAV). A neuropsychiatric examination was performed, including standardized autism diagnostic interviews. Two individuals met diagnostic criteria for autism, one for autistic-like condition, and five for autistic traits. Four patients had mild LD, three severe LD, two profound LD, and two borderline intellectual functioning. Neuroimaging indicated cerebral abnormalities in more than half of the patients. Abnormalities of white/grey matter were found in more than half of examined individuals; enlargement of ventricles in more than a third. Results indicate that at least a subgroup of ASD may be associated with errors in early embryonic brain development. Awareness of the coexistence of OAV/ASD is important in habilitation care of individuals with OAV. [source] Autism spectrum disorders in children with active epilepsy and learning disability: comorbidity, pre- and perinatal background, and seizure characteristicsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2003Suzanne Steffenburg MD PhD The aim of this study was to examine the comorbidity pattern, seizure characteristics, and aetiology in a representative group of children with a combination of autism spectrum disorder (ASD), active epilepsy, and learning disability. Ninety children (47 males, 43 females; mean age 11 years 2 months, range 8 to 16 years at the time of psychiatric examination) with active epilepsy and learning disability, identified in a population-based study in Göteborg, Sweden, were subdivided into those with and those without ASD and compared with respect to aetiology, additional neuroimpairments, and seizure characteristics. In addition, the cohorts were examined for trends of prevalence over a period of time. Results indicated that established aetiology was much more often present in the prenatal period than in the peri- or postnatal periods in the ASD group. Cerebral palsy and visual impairment were under-represented in the ASD group. Partial seizures tended to be more common and generalized seizures less common in the ASD group compared with the non-ASD group. Seizure onset was later in the ASD group. Many of the significant differences were accounted for by a large group of psychiatrically unclassifiable participants in the non-ASD group. There was no trend towards an increase of affected children over the 12-year period. There was no increase in the prevalence of active epilepsy and learning disability nor in the rate of autism with active epilepsy and learning disability in children born between 1981 and 1986 compared with those born from 1976 to 1980, indicating no statistical association with the general measles-mumps-rubella vaccination introduced in the early 1980s. [source] Social interest and the development of cortical face specialization: What autism teaches us about face processingDEVELOPMENTAL PSYCHOBIOLOGY, Issue 3 2002David J. Grelotti Abstract Investigations of face processing in persons with an autism spectrum disorder (ASD) inform upon theories of the development of "normal" face processing, and the story that emerges challenges some models of the nature and origin of cortical face specialization. Individuals with an ASD possess deficits in face processing and a lack of a fusiform face area (FFA). Evidence from studies of ASD can be conceptualized best using an expertise framework of face processing rather than models that postulate a face module in the fusiform gyrus. Because persons with an ASD have reduced social interest, they may fail to develop cortical face specialization. Face specialization may develop in normal individuals because they are socially motivated to regard the face, and such motivation promotes expertise for faces. The amygdala is likely the key node in the system that marks objects as emotionally salient and could be crucial to the development of cortical face specialization. © 2002 Wiley Periodicals, Inc. Dev Psychobiol 40: 213,225, 2002. DOI 10.1002/dev.10028 [source] Links between social and linguistic processing of speech in preschool children with autism: behavioral and electrophysiological measuresDEVELOPMENTAL SCIENCE, Issue 1 2005Patricia K. Kuhl Data on typically developing children suggest a link between social interaction and language learning, a finding of interest both to theories of language and theories of autism. In this study, we examined social and linguistic processing of speech in preschool children with autism spectrum disorder (ASD) and typically developing chronologically matched (TDCA) and mental age matched (TDMA) children. The social measure was an auditory preference test that pitted ,motherese' speech samples against non-speech analogs of the same signals. The linguistic measure was phonetic discrimination assessed with mismatch negativity (MMN), an event-related potential (ERP). As a group, children with ASD differed from controls by: (a) demonstrating a preference for the non-speech analog signals, and (b) failing to show a significant MMN in response to a syllable change. When ASD children were divided into subgroups based on auditory preference, and the ERP data reanalyzed, ASD children who preferred non-speech still failed to show an MMN, whereas ASD children who preferred motherese did not differ from the controls. The data support the hypothesis of an association between social and linguistic processing in children with ASD. [source] Embolization of Atrial Septal Occluder Device into the Pulmonary Artery: A Rare Complication and Usefulness of Live/Real Time Three-Dimensional Transthoracic EchocardiographyECHOCARDIOGRAPHY, Issue 6 2009Harvinder S. Dod M.D. Percutaneous closure of atrial septal defects (ASD) in adults has emerged as an alternative to surgery. We report a rare complication of an atrial septal occluder device embolization into the pulmonary artery which was detected by fluoroscopy and echocardiography. The potential usefulness of live/real time three-dimensional transthoracic echocardiography in the management of patients undergoing percutaneous ASD occlusion is described. (ECHOCARDIOGRAPHY, Volume 26, July 2009) [source] Blood Flow Imaging,A New Angle-Independent Ultrasound Modality for the Visualization of Flow in Atrial Septal Defects in ChildrenECHOCARDIOGRAPHY, Issue 9 2007Siri Ann Nyrnes M.D. Background: Color Doppler imaging (CDI) is the most applied method for evaluation of flow in atrial septal defects (ASD). A new real time ultrasound flow imaging modality called blood flow imaging (BFI) is able to visualize the blood flow in any direction of the image and is not limited by velocity aliasing. The method thereby overcomes the two limitations most often encountered in CDI. In this study we compared BFI with CDI for the visualization of interatrial blood flow in children. Methods: We studied ASD flow in 13 children using both CDI and BFI in the same examination. CDI and BFI cineloops were prepared off-line and both optimal and suboptimal (increased color artifacts) images were presented in random order to four observers. They were asked to range from 0,100 on a visual analogue scale how certain they were of interatrial blood flow. The CDI and BFI ratings were compared using the exact Wilcoxon signed rank test for paired samples. Results: All ASDs visualized with CDI were confirmed using BFI. Two of the observers ranked BFI as being significantly better than CDI when the images were optimized. When the images were suboptimal three of the observers rated BFI as being significantly better. Conclusions: This pilot study indicates that BFI improves the visualization of interatrial blood flow in children. To include BFI in the ordinary echocardiography examination is easy and not time consuming. The method may prove to be a useful supplement to CDI in ASD imaging. [source] Echocardiographic Diagnosis of a Case with Giant Right Atrial AneurysmECHOCARDIOGRAPHY, Issue 2 2006Nesligül Yildirim M.D. Right atrial aneurysm (RAA) is a very rare anomaly. Rarer still is its association with atrial septal defect (ASD). We reported a case of a 42-year-old woman with giant RRA and secundum type ASD detected by means of transthoracic echocardiography. (ECHOCARDIOGRAPHY, Volume 23, February 2006) [source] The role of the medial temporal lobe in autistic spectrum disordersEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 3 2005C. H. Salmond Abstract The neural basis of autistic spectrum disorders (ASDs) is poorly understood. Studies of mnemonic function in ASD suggest a profile of impaired episodic memory with relative preservation of semantic memory (at least in high-functioning individuals). Such a pattern is consistent with developmental hippocampal abnormality. However, imaging evidence for abnormality of the hippocampal formation in ASD is inconsistent. These inconsistencies led us to examine the memory profile of children with ASD and the relationship to structural abnormalities. A cohort of high-functioning individuals with ASD and matched controls completed a comprehensive neuropsychological memory battery and underwent magnetic resonance imaging for the purpose of voxel-based morphometric analyses. Correlations between cognitive/behavioural test scores and quantified results of brain scans were also carried out to further examine the role of the medial temporal lobe in ASD. A selective deficit in episodic memory with relative preservation of semantic memory was found. Voxel-based morphometry revealed bilateral abnormalities in several areas implicated in ASD including the hippocampal formation. A significant correlation was found between parental ratings reflecting autistic symptomatology and the measure of grey matter density in the junction area involving the amygdala, hippocampus and entorhinal cortex. The data reveal a pattern of impaired and relatively preserved mnemonic function that is consistent with a hippocampal abnormality of developmental origin. The structural imaging data highlight abnormalities in several brain regions previously implicated in ASD, including the medial temporal lobes. [source] Profiles of executive function in parents and siblings of individuals with autism spectrum disordersGENES, BRAIN AND BEHAVIOR, Issue 8 2006D. Wong Delineation of a cognitive endophenotype for autism is useful both for exploring the genetic mechanisms underlying the disorder and for identifying which cognitive traits may be primary to it. This study investigated whether first-degree relatives of individuals with autism spectrum disorders (ASDs) demonstrate a specific profile of performance on a range of components of executive function (EF), to determine whether EF deficits represent possible endophenotypes for autism. Parents and siblings of ASD and control probands were tested on EF tasks measuring planning, set-shifting, inhibition and generativity. ASD parents showed poorer performance than control parents on a test of ideational fluency or generativity, and ASD fathers demonstrated a weakness in set-shifting to a previously irrelevant dimension. ASD siblings revealed a mild reduction in ideational fluency and a weakness in non-verbal generativity when compared with control siblings. Neither ASD parents nor siblings displayed significant difficulties with planning or inhibition. These results indicated that the broad autism phenotype may not be characterized primarily by impairments in planning and cognitive flexibility, as had been previously proposed. Weaknesses in generativity emerged as stronger potential endophenotypes in this study, suggesting that this aspect of EF should play a central role in cognitive theories of autism. However, discrepancies in the EF profile demonstrated by parents and siblings suggest that factors related to age or parental responsibility may affect the precise pattern of deficits observed. [source] Unfamiliar face recognition in children with autistic spectrum disordersINFANT AND CHILD DEVELOPMENT, Issue 6 2009Rebecca R. Wilson Abstract We investigated unfamiliar face recognition in low-functioning children with autistic spectrum disorders (ASD) using a ,part-of-face' method. This method has not previously been used for unfamiliar faces with this population. The ,part-of-face' procedure provides measures of both face recognition accuracy and of processing style. We compared the performance of the children with ASD with three control groups: children with developmental delay (DD), typically developing (TD) children matched for verbal cognitive ability and TD children matched for chronological age (CA). Compared to the DD group, the ASD group showed similar processing in recognition accuracy and processing style. Compared to the TD children, the ASD group did not show the same level of accuracy as controls of the same CA, instead showing similar performance to younger TD children. However, as both children with ASD and DD showed the same performance, no ASD-specific deficit was found. Copyright © 2009 John Wiley & Sons, Ltd. [source] Developmental path between language and autistic-like impairments: a twin studyINFANT AND CHILD DEVELOPMENT, Issue 2 2008Katharina Dworzynski Abstract Autism spectrum disorders (ASDs) are diagnosed when individuals show impairments in three behavioural domains: communication, social interactions, and repetitive, restrictive behaviours and interests (RRBIs). Recent data suggest that these three sets of behaviours are genetically heterogeneous. Early language delay is strongly associated with ASD, but the basis for this association and the relationship with individual sub-domains of ASD has not been systematically investigated. In the present study, data came from a population-based twin sample with language development data at 2,4 years, measured by the MacArthur Communicative Development Inventory (MCDI), and data at 8 years using the Childhood Asperger Syndrome Test (CAST). For the total CAST and the three subscales at 8 years, approximately 300 same-sex twin pairs were selected as showing extreme autistic-like traits (ALTs), defined here as pairs in which at least one member of the twin pair scored in the highest 5% of the distribution. Phenotypic analyses indicated that children showing extreme social and communication ALTs (but not the RRBI subscale) at 8 years were below average in language development at 2,4 years. A regression model for selected twin data suggested that genetic influences account for this overlap, but that these effects are only in part mediated by genes that are shared between language and extreme autistic traits. Copyright © 2008 John Wiley & Sons, Ltd. [source] Shared minds: Effects of a mother's imitation of her child on the mother,child interaction,INFANT MENTAL HEALTH JOURNAL, Issue 2 2009Wakako Sanefuji Children with Autistic Spectrum Disorders (ASD) have impaired social interaction right from early development. Previous studies (Dawson & Adams, 1984; Tiegerman & Primavera, 1981, 1984) have suggested that imitating children with ASD is effective in facilitating their social behaviors. The present case report, through a 6-month intervention, investigated how a home-based intervention of helping a mother imitate her 21-month-old child with ASD impacted the child's development of social communication outside the experimental settings. Our results show that the mother's imitation of her child might be associated with the development of nonverbal joint attention skills. Positive changes in the mother's emotion towards her child and the mother,child interaction also were noted and represent other important effects of parental involvement in therapeutic interventions for children with ASD. [source] Behaviour guidance in dental treatment of patients with autism spectrum disorderINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2009CHEEN Y. LOO Background., Autism spectrum disorder (ASD) is a neurodevelopmental disorder categorized into autism, pervasive developmental disorder , not otherwise specified (PDD-NOS) and Asperger syndrome. Aims., To identify factors associated with the behaviour of patients with ASD in a dental setting, use of general anaesthesia (GA), and protective stabilization. Design., The dental charts of 395 patients with ASD patients and 386 unaffected patients were reviewed. The following data were analysed: ASD diagnosis, age, gender, residence, seizure disorder, additional diagnosis (mental retardation, cerebral palsy, self-injurious behaviour or pica), medications, caries prevalence and severity, dental treatment history, behaviour, and behaviour guidance technique(s) used. Results., Within both groups, younger patients were more uncooperative. ASD patients with autism were more uncooperative than patients with PDD-NOS; patients with an additional diagnosis were also more uncooperative. ASD patients with higher caries severity, who were uncooperative or female, were more likely to require GA. Use of protective stabilization was associated with lower caries severity, presence of seizure disorder, uncooperative behaviour, male gender, or residency in a group home/institution. Conclusions., Autism spectrum disorder patients with autism, younger age and an additional diagnosis were more uncooperative. Factors associated with the use of GA and protective stabilization in patients with ASD were also identified. [source] Parenting Stress in Mothers of Children With Autism Spectrum DisordersJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 3 2009Supapak Phetrasuwan PURPOSE., The purpose of this paper is to describe the sources of parenting stress in mothers of children with Autism Spectrum Disorders (ASD) and examine the relationship between parenting stress and maternal psychological status (depression and well-being). DESIGN AND METHODS., A descriptive correlational design was used. Data were collected via mailed questionnaires. RESULTS., Behavioral symptoms were the primary source of parenting stress for mothers. There was no relationship between child characteristics and parenting stress. Mothers reporting more parenting stress had more depressive symptoms and lower levels of well-being. PRACTICE IMPLICATIONS., Our findings have implications for interventions with mothers to help them manage their children's behavior and focus on stress reduction and well-being. [source] Participation of Children with and without Disabilities in Social, Recreational and Leisure ActivitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2010Abbie Solish Background, One method of promoting children's friendship development is through activity participation with peers. However, children with disabilities seem to engage in fewer of these activities, and when they do participate often do so primarily with adults. Materials and Methods, This study compared activity participation and friendship in typically developing (TD) children (n = 90), children with an autism spectrum disorder (ASD; n = 65), and children with an intellectual disability (n = 30) between the ages of 5 and 17 years. Parents completed a questionnaire about their child's participation in social, recreational and leisure activities. Results, The TD children participated in significantly more social and recreational activities and had more friends than the children with disabilities. Notable differences emerged among groups in the percentage of activities the children participated in with peers, parents and/or other adults. Some significant differences were noted between the ASD and intellectual disability groups. Conclusions, Research concerning activity participation should continue to take into account not only whether children are engaging in activities, but explore more precisely ,with whom' these activities are occurring. [source] Third Left Pulmonary Vein with Abnormal Return Associated with Arteriovenous FistulaJOURNAL OF CARDIAC SURGERY, Issue 4 2008Ali Can Hatemi M.D., Ph.D. A 20-year-old woman with complaints of effort-induced dyspnea and easy fatigability was diagnosed with a third left pulmonary vein with abnormal return and arteriovenous fistula accompanied by a secundum atrial septal defect (ASD). Complete surgical repair was performed by ASD closure with a pericardial patch and triple ligation of the left vertical vein and associated third pulmonary vein. The patient was discharged on the seventh postoperative day in good health. Her last control examination was performed in the second postoperative year, revealing normal echocardiographic findings with an excellent clinical course. [source] The Effects of Pentoxifylline on the Myocardial Inflammation and Ischemia-Reperfusion Injury During Cardiopulmonary BypassJOURNAL OF CARDIAC SURGERY, Issue 1 2006Hasim Ustunsoy M.D. The aim of this study is to investigate whether the addition of Ptx into the cardioplegic solutions avoids myocardial inflammatory reactions and ischemia/reperfusion (I/R) injury during extracorpereal circulation. Methods: Between December 1999 and February 2002, we operated 75 patients with the diagnoses of atrial septal defect (ASD), ventricular septal defect (VSD), valve disease, and coronary disease. The average age of patients was 42.4 and male,female ratio was 1: 1.5. The patients were divided into two groups, which were the study group (n = 40) and the control group (n = 35). We used cold blood cardioplegia mixed with St. Thomas' Hospital II cardioplegic solution for both of the groups. Ptx was added into the cardioplegic solution (500 mg/L) in the study group. Interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrotisis factor-, (TNF-,) levels in coronary sinus blood samples during cross-clamp time (X-clamp) and after releasing of it and tissue TNF-, in the right atrial appendix biopsy material that was taken after X-clamp were studied to compare the both groups. Results: After releasing X-clamp, results of blood TNF-,, IL-6, and IL-8 of both groups were statistically significant (p < 0.005). At the pathological examination, we also observed that the amount of tissue TNF-, in the control group (66 ± 17.1) was much higher than the study group (16.6 ± 5.9, p <0.005). Conclusions: These results show that Ptx may be added into cardioplegic solution to avoid the myocardial inflammation and I/R injury during open heart surgery. [source] Mechanisms of Right Atrial Tachycardia Occurring Late After Surgical Closure of Atrial Septal DefectsJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 7 2005ISABELLE MAGNIN-POULL M.D. Introduction: In patients without structural heart disease, the most frequently occurring AT is the common atrial flutter. In patients with repaired congenital heart disease other mechanisms of AT may occur, due to the presence of an atriotomy that can provide a substrate for reentry. The aim of the present study was to identify the mechanisms of atrial tachycardia (AT) occurring late after atrial septum defect (ASD) repair, with the help of a three-dimensional electroanatomical mapping system. Methods and Results: Twenty-two consecutive patients presenting with AT underwent complete electroanatomic mapping (CARTO®, Biosense Webster, Diamond Bar, CA) of spontaneously occurring and inducible right ATs. Complete maps of 26 ATs were obtained. Three tachycardia mechanisms were identified: single-loop macroreentrant atrial tachycardia (MAT) (n = 7), double-loop MAT (n = 18), and focal AT (n = 1). In all MATs, protected isthmuses were identified as the electrophysiological substrate of the arrhythmia, most frequently the cavotricuspid isthmus (CTI) (n = 24), and a gap between the inferior vena cava and a line of double potentials (n = 11). A mean number of 13.5 ± 2.1 radiofrequency applications were delivered to transect these critical parts of the circuit. During a follow-up of 25 ± 16 months the RF ablation was acutely successful in all patients. Thirteen patients (59%) had an early recurrence of MAT and needed an additional ablation procedure. One of those patients needed two additional ablation procedures. Conclusions: Three-dimensional electroanatomic mapping is useful to identify postsurgical AT mechanisms; the CTI isthmus is involved in 92% MAT, and if the right atrial free wall (RAFW) abnormal tissue related to surgical scar is present this substrate contributes to the MAT circuit [source] Paraoxonase 1 activities and polymorphisms in autism spectrum disordersJOURNAL OF CELLULAR AND MOLECULAR MEDICINE, Issue 3 2010Sergiu P. Pa Abstract Autism spectrum disorders (ASD) comprise a complex and heterogeneous group of conditions of unknown aetiology, characterized by significant disturbances in social, communicative and behavioural functioning. Recent studies suggested a possible implication of the high-density lipoprotein associated esterase/lactonase paraoxonase 1 (PON1) in ASD. In the present study, we aimed at investigating the PON1 status in a group of 50 children with ASD as compared to healthy age and sex matched control participants. We evaluated PON1 bioavailability (i.e. arylesterase activity) and catalytic activity (i.e. paraoxonase activity) in plasma using spectrophotometric methods and the two common polymorphisms in the PON1 coding region (Q192R, L55M) by employing Light Cycler real-time PCR. We found that both PON1 arylesterase and PON1 paraoxonase activities were decreased in autistic patients (respectively, P < 0.001, P < 0.05), but no association with less active variants of the PON1 gene was found. The PON1 phenotype, inferred from the two-dimensional enzyme analysis, had a similar distribution in the ASD group and the control group. In conclusion, both the bioavailability and the catalytic activity of PON1 are impaired in ASD, despite no association with the Q192R and L55M polymorphisms in the PON1 gene and a normal distribution of the PON1 phenotype. [source] Stability and individual change in depressive symptoms among mothers raising young children with ASD: maternal and child correlates,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2009Alice S. Carter Abstract Mothers raising children with Autism Spectrum Disorders (ASD) evidence elevated depressive symptoms, but symptom stability has not been examined. Mothers (N=143) of toddlers with ASD (77% boys) were enrolled and assessed when their children were 18 to 33 months old and followed annually for 2 years. Multilevel modeling revealed no significant change in group depressive symptom level, which was in the moderately elevated range (Intercept=13.67; SE=.96). In contrast, there was significant individual variation in change over time. Child problem behaviors and delayed competence, maternal anxiety symptoms and angry/hostile mood, low parenting efficacy and social supports, and coping styles were associated with depression severity. Only maternal anxiety and parenting efficacy predicted individual change. Many mothers do not appear to adapt, supporting the need for early intervention for maternal well-being. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1,11, 2009. [source] A community of practice approach to the development of non-traditional learners through networked learningJOURNAL OF COMPUTER ASSISTED LEARNING, Issue 3 2006K. Guldberg Abstract This paper analyses a sample of online discussions to evaluate the development of adult learners as reflective practitioners within a networked learning community. The context for our study is a blended learning course offering post-experience professional training to non-traditional university students. These students are parents and carers of people with autistic spectrum disorder (ASD). We use Lave and Wenger's ,communities of practice' as a theoretical framework for establishing how students develop a learning community based upon mutual engagement, joint enterprise and shared repertoires. Those three aspects are analysed according to two measures. The first focuses on learner appropriation of the professional discourse, values and goals of the ASD carer through the network. The second relates to changes in the quality of collaborative activity over time. Our analysis demonstrates that students belong to an overarching community of practice, with different subsets who work at sharing and co-constructing common understandings. This shared discourse and common notions of what constitutes good practice help create a safe interaction space for the students. Once group identity is consolidated, more challenging questions emerge and the group are able to define further common values, understandings and goals through processes of resolution. [source] EVALUATION OF DYSPEPTIC SYMPTOMS AND ACID SUPPRESSIVE DRUG (ASD) CONSUMPTION IN SUCCESFULLY ERADI CATED AND HEALED DUODENAL ULCER (DU) PATIENTS; RESULTS OF A ONE YEAR PROSPECTIVE STUDYJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 12 2000Pecsi Gy To determine the upper abdominal symptoms, the use of ASD and the recurrence-rate of Helicobacter pylori in DU (Hp) patients one year after ulcer healing and successful HP eradication. Patient and methods: 37 endoscopically proven healed and successfully eradicated DU patients were successfully recruited in the study. All patients had active ulcer and showed HP positivity both by rapid urease test and histology 5 weeks before the enrollement endoscopy. The severity and character of dyspeptic symptoms and the use of ASD-s were checked by questionnaires at the start and one year after successful eradication therapy. NSAID users and reflux oesophagitis patients were excluded at inclusion. Eradication was performed by a one week LAC combination followed by 4 week ranitidine therapy. HP reinfection was controlled by C13 urea breath test at the 12 month visit. Results: 7 patients were lost for follow up by the end of the one year program. A together the data of 30 eligible patients (17 females, 13 males, mean age 49 years) were analyzed. The questionnaires represent the symptoms and ASD use of the whole year program. Only 12 out of 30 patients (40%) were permanently and completely symptoms free after the cessation of the short-term therapy. 16 patients (53.3%) had temporary and 2 patients (6.7%) had persistant symptom. About half of the patients (n=17) were taking absolutely no ASD during the follow up. The number of occasional and continuous ASD users were 7 (23.4%) and 6 (20%) respectively. HP reinfections occurred in one patient and no ulcer relaps was proven. Conclusions: 1. More than half of the patients had clinically relevant dyspeptic symptoms during the year after successful HP eradication and ulcer healing. 2. The majority of them required occasional or long term ASD therapy in this period. 3. Recurrences rate of HP was low. [source] Objective investigation of the sleep,wake cycle in adults with intellectual disabilities and autistic spectrum disordersJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 10 2006D. J. Hare Abstract Background Disturbances in circadian rhythm functioning, as manifest in abnormal sleep,wake cycles, have been postulated to be present in people with autistic spectrum disorders (ASDs). To date, research into the sleep,wake cycle in people with ASDs has been primarily dependant on third-party data collection. Method The utilization of non-invasive objective recording technologies such as actigraphy permits investigation of both sleep and circadian rhythm functioning in people with ASDs, together with the collection of data on daytime activity. Results Data were collected from 31 participants with intellectual disabilities living in supported community-based residential provision aged between 20 and 58 years, of whom 14 had an ASD. Analysis indicated that there were no significant differences in sleep patterns and circadian rhythm function between those participants with an ASD and those without. Conclusions The mean scores of the participants as a whole indicated abnormalities in the two key circadian rhythm parameters of interdaily stability and intradaily variability. The implications of these findings for both clinical practice and theory are discussed. [source] ASD/PFO Devices: What Is in the Pipeline?JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 6 2007NICOLAS MAJUNKE Since the initial description of an atrial septal defect (ASD) occluding device in the mid-1970s by King and Mills,a number of devices have been developed. To date, various transcatheter devices and methods to close congenital heart defects are currently available commercially or within clinical trials. Devices have been designed specifically for the ASD and patent foramen ovale (PFO). The trend in interventional treatment of intracardiac shunts is toward defect-specific systems and new devices minimizing the foreign material left in the atria. This review first focuses on new devices that are not approved in the United States but are elsewhere, and then reviews the experimental devices for PFO and ASD closure. [source] Transesophageal Echocardiography and Intracardiac Echocardiography Differently Predict Potential Technical Challenges or Failures of Interatrial Shunts Catheter-Based ClosureJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 1 2007GIANLUCA RIGATELI M.D. We sought to prospectively assess the role of transesophageal (TEE) and intracardiac echocardiography (ICE) in detecting potential technical difficulties or failures in patients submitted to interatrial shunts percutaneous closure. We prospectively enrolled 46 consecutive patients (mean age 35±28, 8 years, 30 female) referred to our center for catheter-based closure of interatrial shunts. All patients were screened with TEE before the intervention. Patients who met the inclusion criteria underwent ICE study before the closure attempt (40 patients). TEE detected potential technical difficulties in 22.5% (9/40) patients, whereas ICE detected technical difficulties in 32.5% (13/40 patients). In patients with positive TEE/ICE the procedural success (92.4% versus 100% and, P = ns) and follow-up failure rate (7.7% versus 0%, P = ns) were similar to patients with negative TEE/ICE, whereas the fluoroscopy time (7 ± 1.2 versus 5 ± 0.7 minutes, P < 0.03), the procedural time (41 ± 4.1 versus 30 ± 8.2 minutes, P ± 0.03), and technical difficulties rate (23.1% versus 0%, P = 0.013) were higher. Differences between ICE and TEE in the evaluation of rims, measurement of ASD or fossa ovalis, and detection of venous valve and embryonic septal membrane remnants impacted on technical challenges and on procedural and flouroscopy times but did not influence the success rate and follow-up failure rate. [source] Setting Up a Multidisciplinary Program for Management of Patent Foramen Ovale-Mediated SyndromesJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2006GIANLUCA RIGATELLI M.D. Background: These days no codified multidisciplinary protocol has been reported to manage all the different patent foramen ovale (PFO)-mediated syndromes. We sought to propose a multidisciplinary program of diagnosis, treatment, and follow-up of all PFO-mediated syndromes based on an in-hospital multidisciplinary task force and to review the activities during the first year. Methods: From September 2004, we organized in our hospital, a 600-bed tertiary hospital, a management program for PFO-mediated syndromes based on a task force composed of cardiologists, neurologists, and internists. Different levels of protocols were created in order to cover diagnosis, treatment, and follow-up of PFO-mediated syndromes. We reviewed the activity of our program in the first year up to September 2005. Results: Thirty-five patients (23 female, mean age 65 ± 24 years) were evaluated for suspected PFO-mediated syndromes: 20 for cryptogenic stroke, 2 for peripheral and coronary embolisms, 3 for platypnea-orthodeoxia, 9 for emicrania with aura, and 1 with hypoxiemia during neurosurgical intervention in the posterior cranial fossa. Diagnosis of PFO was confirmed in 25 patients. According to the multidisciplinary protocols, 15 patients failed to meet the requirements for transcatheter closure and were left in medical therapy whereas 11 patients (7 patients with PFO, 2 with multiperforated ASD, and 2 with a secundum ASD) underwent transcatheter closure. After a mean follow-up of 10.8 ± 4.9 months, no recurrent PFO syndromes were noted in patients treated with devices. Conclusion: The first year of our multidisciplinary program allowed a reasonable and potentially successful approach for correctly identifying patients with PFO-mediated syndromes until randomized studies are completed. 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