Screening Children for Autism Spectrum Disorders at 9 Months of Age

New Method of Screening Children for Autism Identification of infants at risk for autism spectrum disorder and developmental language delay prior to 12 months

Summary:
image of Children's National logo
@childrenshealth : more than a hospital,
a health system for kids.

Researchers have identified head circumference and head tilting reflex as two reliable biomarkers in the identification of autism spectrum disorders (ASD) in children that are between 9 and 12 months of age. ASD is identifiable as early as two years old, although most children are not identified until after the age of four. While a number of studies have reported that parents of children with ASD notice developmental problems in children before their first birthday, there has yet to be a screening tool to identify those children.

Abstract:

Studies have shown an increased head circumference and the absence of the head tilt reflex as possible risk factors for autism spectrum disorder, allowing for early detection at 12 months in typically developing population of infants. Our aim was to develop a screening tool to identify infants prior to 12 months at risk for autism spectrum disorder and developmental learning delay, not affected by literacy or primary parental language, and provide immediate determination of risk for autism spectrum disorder. An abrupt head circumference acceleration and the absence of head tilt reflex by 9 months were used to identify infants at risk for autism spectrum disorder. Stability of early findings was then investigated when compared to comprehensive standardized neurodevelopmental assessment results and complete neurological and genetics evaluations. A total of 1024 typically developing infants were enrolled by 9 months, with 14 identified as at risk for autism spectrum disorder and 33 for developmental learning delay. There was a good positive predictive value for the identification of autism spectrum disorder prior to 12 months. This study demonstrates an efficient means to identify infants at risk for autism spectrum disorder by 9 months of age and serves to alert primary care providers of infants who are vulnerable for autism spectrum disorder before symptoms are discernible by clinical judgment of primary care providers, parental concerns, or by screening questionnaires.

Sources:
  • New Method of Screening Children for Autism Spectrum Disorders Works at 9 Months Old, Year Sooner than Average Screening Age, ChildrensNational, NewsReleases, April 14, 2014
  • Full text: Identification of infants at risk for autism spectrum disorder and developmental language delay prior to 12 months, The National Autistic Society, SAGE Publications, Feb 18, 2014

Who’s paying your Doctor?

With the NHS drug bill topping £10 billion in 2013, this BBC investigation examines the tactics employed by drug companies to tap into that lucrative market and influence which medicines your doctor prescribes

With the NHS drug bill topping £10 billion in 2013, this investigation examines the tactics employed by drug companies to tap into that lucrative market and influence which medicines your doctor prescribes.

Strict rules govern drug company spending in the UK, but still they pay out millions to doctors to attend and speak at conferences. Panorama goes undercover to see this subtle persuasion at work and asks whether you should have the right to know who is paying your doctor.

And as Britain’s most profitable drug company, GlaxoSmithKline, waits to hear whether it will face criminal charges following allegations of bribery in China, the programme reveals new evidence that GSK was recently paying doctors to boost prescriptions much closer to home, in Europe.

More info and Videos

Identifying Diethylstilbestrol DES Exposure and Future Considerations

Although diethylstilbestrol has not been given to pregnant women in the United States for more than 30 years, its effects continue to be seen

Abstract

image of PubMed NCBI The Endocrine Society logo
Although diethylstilbestrol has not been given to pregnant women in the United States for more than 30 years, its effects continue to be seen.

Diethylstilbestrol (DES) is a synthetic nonsteroidal estrogen that was used to prevent miscarriage and other pregnancy complications between 1938 and 1971 in the United States. In 1971, the U.S. Food and Drug Administration issued a warning about the use of diethylstilbestrol during pregnancy after a relationship between exposure to this synthetic estrogen and the development of clear cell adenocarcinoma of the vagina and cervix was found in young women whose mothers had taken diethylstilbestrol while they were pregnant. Although diethylstilbestrol has not been given to pregnant women in the United States for more than 30 years, its effects continue to be seen. Women who took diethylstilbestrol during pregnancy have a slightly higher risk of breast cancer than the general population and therefore should be encouraged to have regular mammography. Women who were exposed to diethylstilbestrol in utero may have structural reproductive tract anomalies, an increased infertility rate and poor pregnancy outcomes. However, the majority of these women have been able to deliver successfully. Recommendations for gynecologic examinations include vaginal and cervical digital palpation, which may provide the only evidence of clear cell adenocarcinoma. Initial colposcopic examination should be considered; if the findings are abnormal, colposcopy should be repeated annually. If the initial colposcopic examination is normal, annual cervical and vaginal cytology is recommended. Because of the higher risk of spontaneous abortion, ectopic pregnancy and preterm delivery, obstetric consultation may be required for pregnant women who had in utero diethylstilbestrol exposure. The male offspring of women who took diethylstilbestrol during pregnancy have an increased incidence of genital abnormalities and a possibly increased risk of prostate and testicular cancer. Routine prostate cancer screening and testicular self-examination should be encouraged.

Sources:
  • Diethylstilbestrol exposure, NCBI, PMID: 15168959, 2004 May 15;69(10):2395-400
  • Full text – Diethylstilbestrol Exposure, American Family Physician, 2004/0515/p2395, 2004 May 15;69(10):2395-2400.
More DES DiEthylStilbestrol Resources

Causation and Risk in the Law of Torts

This book provides a comparative account of the legal and scientific issues relating to proof of causation in alleged cases of drug-induced injury

Scientific Evidence and Medicinal Product Liability

Professor Richard Goldberg is Chair of LLB Board of Examiners, Durham Law School.

image of Causation and Risk in the Law of Torts book cover
Causation and drugs: the legacy of diethylstilbestrol.

Description
This book provides a comparative account of the legal and scientific issues relating to proof of causation in alleged cases of drug-induced injury, principally in Europe and North America. It seeks to assess whether, by using probabilistic approaches, the courts may more accurately determine the cause of adverse reactions contentiously associated with drugs. In four case studies (DES, Bondoctin, vaccine damage and “Gulf War Syndrome”), the deficiencies of orthodox approaches to causation are revealed. A sustained argument is presented in favour of according greater weight to epidemological statistics, as refined by the application of the Bayes’ Theorem. A valuable feature is the discussion of the role of expert witnesses, including an examination of how the author’s proposals could be accommodated within the reformed civil process envisaged by the Woolf Report. The book also examines the economic implications of these proposals. It is a timely contribution to the resolution of the legal problems in this complex area of tort law.

Table Of Contents

  • causation and medicinal products – a legal and probability analysis
  • diethylstilbestrol and causation
  • scientific evidence, causation and the law, lessons of Bendectin (debendox) litigation
  • vaccine damage and causation – a comparative perspective
  • causation, medicinal products and the Gulf War Syndrome
  • causation and medicinal products – an economic analysis; the development risk defence and medicinal products
  • possible economic consequences of probabilistic approaches to causation
  • conclusion
More DES DiEthylStilbestrol Resources

3D Model of Cancer Cells successfully created to study Cancerous Tumours

Three-dimensional printing of Hela cells for cervical tumor model in vitro

image of 3-D printing cancer cells to mimic tumors
With the advent of 3D printing, it is now possible to provide a more realistic representation of the environment surrounding a cancer cell. 
Image courtesy of IOP @PhysicsNews

A 3-D model of a cancerous tumor using a 3-D printer has been successfully created by a group of researchers in China and the US. The model consists of a grid structure, 10 mm in width and length, made from gelatin, alginate and fibrin, which recreates the fibrous proteins that make up the extracellular matrix of a tumor. ” With further understanding of these 3D models, we can use them to study the development, invasion, metastasis and treatment of cancer using specific cancer cells from patients. We can also use these models to test the efficacy and safety of new cancer treatment therapies and new cancer drugs.” Professor Wei Sun, from Tsinghua University, China, and Drexel University, USA, the lead author of the research stated.

Sources:
  • Press release: 3D printing cancer cells to mimic tumours
    Institute of Physics, IOP News 11 April 2014.
  • Study: Three-dimensional printing of Hela cells for cervical tumor model in vitro
    IOP Science, doi:10.1088/1758-5082/6/3/035001 11 April 2014.

Les liens d’intérêts non déclarés de 78 cancérologues français, une étude du Formindep

Cancer et médias : l’information ne tolère pas l’approximation

logo du Formindep
Association pour une Formation et une information médicales indépendantes de tout autre intérêt que celui de la santé des personnes.

Jérôme Vincent, journaliste, publie dans l’hebdomadaire Le Point du 26 novembre 2013 un article intitulé “Médicament dangereux du mois – Avastin, inefficace contre le cancer“.
Se constitue alors un collectif de soixante dix-huit oncologues qui réagit pour défendre cette spécialité pharmaceutique et les Laboratoires Roche qui la commercialise.

L’AVASTIN®, bévacizumab, est le chef de file des anticorps monoclonaux dirigés contre un facteur VEGF. Il est l’anticancéreux le plus onéreux en France et dans de nombreux pays. François Pesty, membre du Formindep, enquête et découvre que les cancérologues français avaient omis de déclarer leurs conflits d’intérêts majeurs

Lisez Les leaders d’opinion d’une firme pharmaceutique influencent la rédaction du Point, Parcours du combattant pour l’exercice d’un journalisme indépendant, François Pesty, 11 avril 2014.

Hypospadias: a TransGenerational effect of DiEthylStilbestrol?

The 2005 study results confirm an increased risk of hypospadias when mothers were exposed to DES in utero

Abstract

image of PubMed NCBI The Endocrine Society logo
The results confirm an increased risk of hypospadias when mothers were exposed to DES in utero.

BACKGROUND:
In 2002, an increased risk of hypospadias was reported for sons of women exposed to diethylstilbestrol (DES) in utero, suggesting transgenerational effects of DES. The aim of this study was to further assess the association between parental DES exposure and hypospadias in a case-referent study.

METHODS:
Cases with hypospadias were retrieved from the hospital information system. Referents were recruited via the parents of cases. Both parents completed postal questionnaires. Associations were estimated by odds ratios (OR) with 95% confidence intervals (CI). Additionally, conditional logistic regression analyses were performed for a matched subset of parents.

RESULTS:
The final database included 583 cases and 251 referents. In the initial analyses, an indication was found for an increased risk of hypospadias when mothers were exposed to DES in utero: OR=2.3 (95% CI 0.7-7.9). Conditional logistic regression resulted in a stronger risk estimate: OR=4.9 (95% CI 1.1-22.3). Paternal exposure to DES did not increase the risk.

CONCLUSIONS:
The results confirm an increased risk of hypospadias when mothers were exposed to DES in utero. However, the excess risk appears to be of much smaller magnitude than in the 2002 study. Further research on the potential health risks for the third generation is of great importance.

Sources
  • NCBI, Hypospadias: a transgenerational effect of diethylstilbestrol?, PMID: 16293648, 2006 Mar;21(3):666-9. Epub 2005 Nov 17.
  • Oxford Journals, Full Article, Medicine, Human Reproduction, Volume 21, Issue 3, Pp. 666-669., 2005.
More DES DiEthylStilbestrol Resources

Tissue engineered Vaginal Reconstruction: Lab-grown Vaginas successfully implanted into Young Women

Four young women have had new vaginas grown in the laboratory and implanted by doctors in the U.S.

Doctors implant lab-grown vaginaScientists have successfully implanted vaginas grown in laboratories into four teenage girls who have a congenital condition which meant their own did not develop properly.

The artificial vaginas, engineered from the patient’s own cells and individually made to fit them, allowed the young women to later have full sex lives. As well as being a breakthrough in vaginal reconstruction, the US and Mexican scientists responsible for the procedures said it potentially meant other tissues or organs could be laboratory grown and implanted.

Study and press releases – 11 April 2014:
  • Tissue-engineered autologous vaginal organs in patients: a pilot cohort study, The Lancet, doi:10.1016/S0140-6736(14)60542-0.
  • Doctors implant lab-grown vagina, BBC News, health-26885335.
  • Vaginas grown in labs successfully implanted into girls with rare disorder, The Guardian, Sexual health.
  • Lab-grown vaginas prove long-term success for four women born without one, The Independent, Science.

Secret Toxic Chemicals in Feminine Products, Tampons and Pads

Toxic chemicals do not belong in feminine products.
Tell Tampax and Always to Detox the Box!

Toxic chemicals don’t belong in feminine products. Period.

image of Secret Toxic Chemicals in Tampons and Pads
Toxic chemicals don’t belong in feminine products. Period.

Tell Tampax and Always to Detox the Box!

Women’s Voices for the Earth November 2013 Chem Fatale report found toxic chemicals commonly used in feminine care products like pads and tampons. ” Unfortunately, because pads and tampons are regulated as “medical devices” and not “personal care products,” companies aren’t required by law to disclose any of the ingredients used in these products. We know that Procter & Gamble, makers of Tampax and Always, uses some toxic fragrance chemicals – and we have a right to know what else they’re using in pads and tampons. ”

Sources and More Information

On Flickr®

DiEthylStilbestrol Resources: Fertility and Pregnancy

NCBI advances science & health by providing access to biological information

DES and Fertility

DES and Pregnancy

More DES DiEthylStilbestrol Resources