North American Journal of Medicine and Science
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Study on P50 Sensory Gating in Children with Autism Spectrum Disorders in Shanghai
Get PDFUnusual reactions to auditory stimuli are often observed in autism and may relate to ineffective inhibitory modulation of sensory (P50 sensory gating). Sensory gating deficit may, however, characterize children with autism spectrum disorders (ASD) reflecting imbalance of neuronal excitation/inhibition in these cohorts. We applied a paired clicks paradigm designed by American Nicolet Bravo Instrument to study P50 sensory gating in children with autism (N=39) and age-matched typically developing children (N=31). The incubation period to auditory stimuli in children with ASD was significantly longer than typically developing children. The data suggests that P50 sensory gating is deficit in children with ASD. The latency of response to the second click was not significantly reduced in children with ASD. The speed of processing auditory stimulation is slower in children with autism than typically developing children. The sensory gating P50 in the autistic children is impairment, and won’t improve with the age. The speed of processing sound stimulus in autistic children is much slower than that of control group. The speed of processing sound stimulus in autistic children will increase with the age. The sensory gating P50 in normal control is active and it is improving with the age
A Review of the Natural History of Chronic Hepatitis C Infection
Get PDFThe burden of chronic hepatitis C infection worldwide is significant. Approximately 4.1 million people in the United States have anti-HCV antibodies. The prevalence worldwide varies, but reaches greater than 3.5% in some regions (North African, East Asia). The burden of hepatitis C virus is reflected in the morbidity and mortality of this disease, as well as the societal costs. The morbidity and mortality associated with chronic hepatitis c infection is mostly related to the rate of fibrosis and associated progression to cirrhosis. The natural history of this progression is a complex and dynamic process related to individual characteristics (age, sex, race, genetics), viral characteristics (genotype), behavioral (smoking, alcohol), metabolic factors (insulin resistance, obesity), and co-infection (Hepatitis B and HIV). This review describes the current literature on how these factors interact with chronic hepatitis C infection and impact the natural history of this disease and progression to fibrosis and cirrhosis.
Management of Chronic Hepatitis C among Asian Americans
Get PDFChronic hepatitis C (CHC) affects 170 million people worldwide and is a risk factor for end-stage liver disease and hepatocellular carcinoma. The majority of patients with CHC are from Asian descent (94.6 million); however, CHC is an underappreciated disease in Asian patients. The goal of this study is to review the current literature on Asians with CHC. A PubMed search was used to review the pertinent literature for Asians with CHC.This research has revealed that Hepatitis C virus (HCV) positivity in Asians tends to mirror the prevalence found in the patient’s native country. Asian patients with CHC rarely present with well-known risk factors. The most common genotype in East Asia and South Asia is genotype 1b while genotype 6 is more commonly found in Southeast Asia. Asian patients have superior rates of sustained virologic response (SVR) rates than their non-Asian counterparts regardless of HCV genotype. As the conclusions of this research, we recommend screening for HCV in Asians if the prevalence of a patient’s native country is equal to or exceeds 2%. Additional studies are needed to explore the ethnic differences in patients with CHC
Validity of Fine Needle Aspiration Cytology in Diagnosis of Prostatic Lesions and Correlation with Trucut Biopsy
Get PDFProstate fine needle aspiration (FNA) is an easy-to-perform outpatient procedure requiring no expensive equipment or anesthesia. The aim of this study was to analyze the cytomorphology of prostatic lesions and to correlate the findings in cytology with that of the histopathological appearance. In doing so we also assessed the diagnostic accuracy of fine needle aspiration cytology and identified possible pitfalls. The study was carried out in 100 patients who underwent tru-cut biopsy in the department of Urology at Kottayam Medical College, India during the period spanning from March 2010 to March 2011. Fine needle aspiration cytology (FNAC) was done with Franzen needle and followed by tru-cut biopsy after which the results of both were compared. FNAC gave a benign diagnosis in 64 cases and identified a malignant pattern in 36 cases. The overall accuracy of FNAC in this series in diagnosing prostatic lesions was 97% with a sensitivity of 100% and specificity of 95.5%. This shows that FNAC prostate is a reliable, relatively painless tool, which can be used for the diagnosis of prostatic carcinoma, especially in patients with high risk complications such as bleeding and infections in whom a tru-cut biopsy is more invasive. In addition it is also cost-effective and may sample a larger area
Can Awareness of Medical Pathophysiology in Autism Lead to Primary Care Autism Prevention Strategies?
Get PDFEmerging research suggests that the timing of environmental factors in the presence of genetic predispositions has influenced the increase in autism spectrum disorders over the past several decades. A review of the medical literature suggests that autism may be impacted by environmental toxicants, breastfeeding duration, gut flora composition, nutritional status, acetaminophen use, vaccine practices and use of antibiotics and/or frequency of infections. The author reports her retrospective clinical research in a general pediatric practice (Advocates for Children), which shows a modest trend toward lower prevalence of autism than her previous pediatric practice or recent CDC data. Out of 294 general pediatrics patients followed since 2005 there were zero new cases of autism (p value 0.014). Given the prevalence of autism for that cohort of 1 in 50 children in the United States, it is important to consider implementing strategies in primary care practice that could potentially modify environmental factors or affect the timing of environmental triggers contributing to autism. [N A J Med Sci. 2013;6(3):134-144. DOI: 10.7156/najms.2013.0603134]
Rhythm Definition of Biomarkers for an Objective Measure of Autism
Get PDFA review of the literature noted 16 biomarker candidates that could be utilized to develop an objective measure of autism, and we found that 11 of them were quantifiable in saliva collected twice in the evening from 12 neurotypical adults. These biomarkers (and body systems) in which autism is manifest were: Glutamine and Glutamic acid (ubiquitous), CD26 (gastrointestinal); C4B and IFNγ (immunologic); Cortisol, Melatonin, Testosterone (neurologic); and GSH, GSSG, Metallothionein-2 (toxicologic). These 11 biomarkers also monitor the three unifying concepts of the cause of autism: oxidative stress, immune glutamatergic dysfunction, and pineal gland malfunction. Saliva was used since, of the typical body fluids, its collection is least stressful to the individual. Because the concentrations of biomarkers can vary dramatically over 24-hours, circadian studies are being planned, since defining the circadian rhythm of each biomarker will allow future testing using as few assays at appropriate times as necessary in order to obtain a valid objective measure of autism. A diagnosis based on chemical measurements can then be made, resulting in a patient-specific profile that will rank the biomarkers in the order of their difference from normal. It is hoped that this profile will provide a guide for biomarker replacement therapy to improve the symptoms of autism, as has been demonstrated for melatonin and several components of the methionine cycle (involved in detoxification).[N A J Med Sci. 2013;6(3):154-157. DOI: 10.7156/najms.2013.0603154
Biobanking of Residual Specimens from Diagnostic Genetic Laboratories: Standard Operating Procedures, Ethical and Legal Considerations, and Research Applications
Get PDFClinical applications of high-throughput technologies such as microarray analysis, next generation sequencing and tandem mass spectrometry have significantly improved the diagnostic performance and research capacity for many genetic diagnostic laboratories. Biobanking of patients’ residual specimens and test records could be a useful resource for further research applications but related technical, ethical and legal issues need to be resolved. In this review, standard operating procedures and laboratory information management system for short-term and/or long term storage of residual original patient specimens and processed patient specimens have been outlined. To comply with current ethical and legal requirements, procedures for case-oriented consent, general informed consent and waiver of consent as well as methods for returning incidental findings and individual research results have been summarized. Diagnostic residual specimens have been used in many research projects to improve clinical quality and to characterize genetic defects for underlying disease-causing mechanisms. The advantages and disadvantages of diagnostic biobanking for research applications have been discussed. A model of ‘Diagnostics-Biobanking-Research-Returning’ is proposed to promote rapid transition and effective collaboration from diagnostic to research and eventually provide better preventive and therapeutic approaches for patients with genetic disorders. [N A J Med Sci. 2013;6(4):200-207. DOI: 10.7156/najms.2013.0604200
Is Dietary Fatty Acid a Risk Factor for Obesity? A Review of the Literature
No full textObesity is an important modifiable risk factor for many chronic diseases. With the dramatically increased prevalence of obesity over the last 2 to 3 decades, obesity pandemic has become a major public health challenge worldwide. Finding strategies to prevent the development of obesity are of critical importance to reduce the population burden of obesity and obesity related disorders. The role of high fat intake as a main contributor to obesity remains controversial. Experimental studies have suggested that the composition of dietary fats may be relevant to the development of obesity independent of total fat intake. However, very few epidemiologic studies have prospectively investigated the associations between intake of different fats and body weight gain. The intrinsic inaccuracy in diet assessment using self-reported method has particularly limited the extent to which most previous epidemiologic studies can reveal the true relation between dietary fat and disease outcomes. More objective measures of dietary fat profile, such as fatty acids composition in biologic specimens, is superior in hypothesis testing but has rarely been used in studies of obesity. Furthermore, individual responses to dietary fats may vary based on their genetic backgrounds. Differential sensitivity to fat-induced obesity has been mapped to specific genetic loci in animal models but is much less studied in humans. Further genetic association studies are needed to explore potential interactions between dietary fats and genetic variants underlying the development of obesity
Optimal Lymph Node Harvest in Neoadjuvantly Treated Colorectal Cancer Using Methylene Blue Assisted Lymph Node Dissection Technique
No full textLymph node staging is still of crucial importance in rectal cancer. However, the recommendation to evaluate at least 12 lymph nodes for a sufficient staging is often not achieved in daily practice. This problem is even more pronounced after neoadjuvant treatment. The methylene blue assisted lymph node dissection technique (MBLND) has been shown to improve lymph node harvest in gastrointestinal cancers very effectively. A retrospective analysis enrolling 54 cases was performed to investigate the effect of MBLND in neoadjuvantly treated rectal cancer cases. Two historical collections evaluated using conventional dissection technique (n = 47) and fat clearance (FC) technique, respectively served as controls (n = 12). The lymph node harvest was highly significantly improved in the methylene group compared to fat clearance and conventional dissection with mean LN numbers of 29 ± 11, 21 ± 13, and 9 ± 4 (P < 0.001), respectively. Insufficient LN harvest occurred in 72 % of the control group cases, in 17 % of the FC-group and in no case of the Methylene group. Node positivity was found in 24%, 25% and 28% in the MB-, FC- and control group, respectively. MBLND is a highly effective method guaranteeing an optimal lymph node harvest in colorectal cancer even under the difficult conditions of preoperative chemo-radiation. In our hands it was even more effective than a fat clearance technique
Stress and Mental Flexibility in Autism Spectrum Disorders
Get PDFCognitive deficits are well-established core features in autism spectrum disorders (ASD). In this paper, we review representative studies on cognitive flexibility, which is one type of neuropsychological weakness that is often related to repetitive and restricted clinical symptoms in ASD. We also review effects of stress in both typically developing individuals and in individuals with ASD, to show the importance of this factor in modulating relationships between cognitive inflexibility and clinical symptoms related reflecting inflexibility, such as repetitive and restricted behaviors. Finally, we present three case vignettes involving higher functioning individuals to illustrate some of these relationships in individuals, and to suggest the utility of clinical interventions. [N A J Med Sci. 2013;6(3):145-153. DOI: 10.7156/najms.2013.0603145