Autism and celiac disease: failure to validate the hypothesis of a possible link

Autism is a heterogeneous condition and the possible pathogenic role of several different factors was postulated. Previous studies reported the existence of a linkage between autism and celiac disease [CD]. The aim of this study was to determine the association between autism and CD by anti-gliadin [AGA], anti-endomysial [AEA] and tissue transglutaminase [tTG] antibodies. Thirty four consecutive autistic children [18 boys and 16 girls] aging 9.2 +/- 4.1 years [range 4-16 years] and thirty four age- and sex- matched healthy anonymous blood donors [18 boys and 16 girls] aging 10.8 +/- 4.0 years [range 4-16 years] were included. None of the patients and controls had symptoms [or positive family history] suggestive of specific gastrointestinal diseases. AGA and AEA antibodies [lgG and IgA], and lgA-tTG were detected by ELISA. The individuals with positive serology were offered duodenal biopsies. lgG-AGA was found in 4 patients [11.8%] and 2 controls [5.9%], while IgA-AGA was found in none of the patients and controls. All patients presented normal values of lgG and lgA-AEA similar to the control group. There was no significant relationship between the levels of AGA and AEA antibodies and the severity of autism in the patient group. The levels of lgA-tTG in four patients [but no controls] were in the borderline range and two of them were found to have mild villous changes with chronic inflammatory cells. However, characteristic histological features of CD were absent. No evidence was found that children with autism were more likely to have celiac disease than children without autism

Effects of 6 months of treatment with donepezil and rivastigmine on results of neuropsychological tests of MMSE, NPI, clock and bender in patients with Alzheimer's disease

Alzheimer's disease is the most common degenerative disease of brain. Nowadays, acetyl cholinesterase inhibitors, including donepezil, rivastigmine and galantamine, are standard treatments to slow down disease progression. Purpose of our study was to show effects of treatment with donepezil and rivastigmine and to compare these effects between two drugs. Samples selected from patients who had Alzheimer disease with DSM IV criteria and were candidate of receiving donepezil or rivastigmine for the first time. We used four neuropsychological tests including MMSE, NPI, Clock and Bender to assess patient's cognitive and behavioral changes during treatment with two drugs. Patients divided to two groups [each group 35 cases], one group taking donepezil and the other rivastigmine. The four tests were completed once before starting treatment and then, 1 month, 3 months and 6 months after treatment with Donepezil and Rivastigmine. MMSE, 6 months after treatment with Donepezil, improved from 20.63 before treatment to 21.83, which was statistically significant. Also, MMSE, 6 months after treatment with Rivastigmine, improved from 20.03 before treatment to 22.71, which was statistically significant. About Clock test, there was a significant improvement from 5.74 before treatment to 6.4 after 6 months of treatment with Rivastigmine; while this significant improvement was not seen in patients receiving Donepezil. In two other tests, no significant differences were seen before and after treatment. Also, No significant difference was detected between two groups and so no different effects on these tests between Donepezil and Rivastigmine in 6 months period of treatment

[Examination of mechanisms involved in spasticity reduction after BTX-A injection in hemiplegic patients]

Spasticity is a common and disabling complication that occurs as a result of upper motor neuron lesion. Recently, Botulinum Toxin - A [BTX-A] has received a pronounced position in spasticity treatment because of its efficacy, high capability of selective effects and low side effects. In this study, through electrophysiologic tests, mechanisms involved in spasticity reduction following BTX-A injection were studied. This descriptive study was carried out in the year 2006, on 15 hemiplegic patients [age ranged 44- 70 yrs] with spasticity of ankle plantar flexors at Tehran University of medical Sciences. According to the Original Ashworth Scale [OAS], before and after intervention, spasticity of muscles was assessed. Electrophysiologic measurements consisted of amplitude of maximum H- reflex, M response and H / M ratio of soleus muscle, were recorded before and after injection. Toxin was injected in Gastrocnemius [200 units], soleus [75 units] and posterior tibialis muscles [50 unit]. Data were recorded in a questionnaire and analyzed by descriptive statistics and frequency distribution tables. Four weeks after injection, significant reduction in H- reflex, M response amplitudes and H / M ratio were seen. According to the OAS, severity of spasticity also, showed a meaningful reduction. H - Reflex amplitude had more expressive reduction than M response. Reduction of H -reflex amplitude and H / M ratio is the result of toxin effect on intrafusal fibers and reduction of M response amplitude is the result of toxin effect on extrafusal fibers. More significant reduction of H - reflex amplitude in comparison to M response, showed that BTX-A can reduce the spasticity through modification of gamma motor neuron system. Results of this study could help the therapists, in selecting the most efficient therapeutic exercises, for application after the BTX-A injection

[ study on the results of competing sentence test in patients with cerebrovascucular accident]

Background: Cerebrovasular diseases [CVD] are one of the most common anomalies which may affect on auditory cortex. In this research we have tried to evaluate the function of CANS in a group of 50-70 years old cerebrovascular accident [CVA] patients without hearing problem by using Persian version of C.S.T

Materials and Methods: This cross-sectional analytic study was established at Loghman-e-Hakim Hospital on a group of 30 normal subject [15 male, 14 female] and a group of 40 patients with CVA including 30 patients [16 male, 14 female] with abnormal CT scan and 10 patients with normal CT scan

Results: Routine audiologic test including: Pure tone audiometry, Immitance audiometry and speech audiometry were nearly normal in all cases. There were significant differences between mean scores of CST in the patients with CVA and control group [P< 0.05]. There were no significant differences between mean scores of CST in male and females [P> 0.05]. In spite of nearly normal hearing and high scores in the simple speech tests such as SDS, there were significant differences in mean scores of CST in both ears of CVA patients [P< 0.05]. Another important point is that in some of patients with CVA

Conclusion: Although common radiologic evaluations such as CT scan showed no anatomic or structural anomaly but central auditory assessments such as CST can show dysfunctions of CANS. Therefore, CST might be a valuable test in CANS batteries for the cerebrovascular diseases

Unusual form of coronary artery fistula associated with a single coronary artery

Congenital coronary arterial malformations have long been recognized, and the frequency of these reports in the literature has increased greatly since the widespread use of selective coronary angiography. The authors report an unusual case of coronary arteriovenous fistula with two abnormal branches of the left anterior descending [LAD] artery terminating in the right ventricle associated with a single coronary artery [and absence of the right coronary artery]. The patient was operated successfully and all symptoms and signs disappeared