PLASMATIC LEVELS OF NEUROPEPTIDES, INCLUDING OXYTOCIN, IN CHILDREN WITH AUTISM SPECTRUM DISORDER, CORRELATE WITH THE DISORDER SEVERITY.

CONTEXT: Oxytocin has been investigated as a potential medication for psychiatric disorders. OBJECTIVE AND DESIGN: This study prospectively investigates correlations between oxytocin and other neuropeptides plasma levels in patients with autism spectrum disorders (ASD) according to severity and treatment, as compared to controls. SUBJECTS AND METHODS: Thirty-one children (6 neurotypical as control) participated in this study. The patients were classified into mildly and severely-affected, according to Autism Diagnostic Observation Schedule (ADOS) scores. Oxytocin, orexin A and B, α-MSH, ß-endorphins, neurotensin and substance P were investigated using a quantitative multiplex assay or a competitive-ELISA method. RESULTS: Plasma oxytocin levels differed between the groups (F (2, 24) =6.48, p=0.006, η2=0.35, observed power=86%): patients with the mild ASD had higher values of plasma oxytocin than those with the severe form (average difference=74.56±20.74pg/mL, p=0.004). CONCLUSIONS: These results show a negative correlation between plasma levels of oxytocin and the severity of ASD and support the involvement of oxytocinergic mechanisms in ASD.

Comparative Doppler flow measurements of the ulnar artery and of the postanastomotic radial artery in radiocephalic arteriovenous fistulas to detect steal syndromes.

OBJECTIVE: This study aims to assess whether a comparison of the Doppler flow measurements of the ulnar artery and of the postanastomotic radial artery can help detect steal syndromes at the level of native dialysis fistulas of the wrist. PATIENTS AND METHODS: We have prospectively analyzed 35 distal radiocephalic arteriovenous fistulas presenting with postanastomotic radial artery Doppler inversion of flow. The flows of the ulnar artery and of the postanastomotic radial artery have been measured and compared. Subsequent clinical examination to detect any sign of ischemia at the hand level was performed and the results of medical imaging were confronted with the clinical data. RESULTS: A steal syndrome was discovered in a total of 6 patients (17%), 4 patients out of 23 displaying an ulnar flow lower than the postanastomotic radial one and 2 patients among 12 with an ulnar flow higher than the radial one. Sensitivity, specificity, positive predictive value and negative predictive value of the test were 67%, 34%, 17% and 83%, respectively. Paradoxically, the mean intensity of ulnar flow deficiency has been measured at 40% among true positive patients and at 70% among false positive ones. We have not been able to identify any difference, be it in terms of systolic upstroke time, maximum systolic speed, telediastolic speed or in terms of global architecture of the curves between the Doppler waveforms of 4 true positive and 4 false positive patients. CONCLUSION: The comparative Doppler study of the flows of the ulnar and postanastomotic radial arteries does not enable us to detect steal syndromes at the level of wrist dialysis fistulas. Hence we consider that a systematic study of the postanastomotic radial artery flow, during routine Doppler examination of distal dialysis fistulas, proves superfluous.

Evaluation at patients with ventricular arrhythmias and coronary artery disease of myocardial revascularization effects.

UNLABELLED: The aim of this study was to determine the relations between myocardial revascularization therapy--coronary artery bypass graft (CABG) and coronary angioplasty (PTCA)--and ventricular potentially malignant arrhythmia (VPMA) (coupled VPC, VPC > 10/hour, NSVT--Morganroth classification), in patients (pts) with stable CAD. METHODS: 765 patients with stable angina and ventricular potentially malignant arrhythmia were evaluated angiochoronarographically, echographically, by programmed electrical stimulation (PES), standard ECG, Holter ECG, radiologically, and by stress test. From 765 patients with CAD and VPMA 169 pts. (22.9% of cases) were revascularized, 77 pts. (10.06% of cases) by CABG surgery and 82 pts. (10.71% of cases) by PTCA with or without stenting. RESULTS: From pts. with inducible sustained ventricular tachycardia by programmed electrical stimulation PES + (129 pts. 16.86% of cases), 19 pts. (2.5% of cases) were with CABG vs 9 pts. (1.17% of cases) with PTCA (p > 0.05). In 333 pts. with arrhythmogenic myocardic ischemia detected by Holter ECG/24 hours (Holter +) the distribution of myocardial revascularization was similar (40 pts., 5.22% of cases with CABG vs 46 pts., 6.01% of cases with PTCA) (p > 0.05). The study included 225 pts. with positive stress test, 45 pts. were revascularized, 18 pts. (2.35% of cases) with CABG and 27 pts. (3.52% of cases) with PTCA (p > 0.05). Revascularized pts. represent an increased percent with prior myocardial infarction in the subgroup with CABG vs. PTCA (39% of cases, p < 0.05 vs. 25% of cases, p < 0.05). Revascularized pts. presented similar distributions of VPMA in subgroups with CABG and PTCA. CONCLUSIONS: VPMA was not influenced by myocardial revascularization, CABG or PTCA, the incidence being similar (50.94% vs 47.2%; p < 0.05) with pts. drug treated.

Restenosis in the coronary stent is an argument for the surgical myocardial revascularization.

BACKGROUND: This study will evaluate the difference between the frequency of restenosis in myocardial revascularization procedures by stents and CABG by coronarographic control after clinical criteria (angina). METHODS AND RESULTS: Out of the total of 6564 coronarographies performed (1999-2002) for diagnosis purposes, 3110 patients (44.8%) underwent myocardial revascularization procedures, PCI or CABG. PCI was performed in 981 patients (31%) and CABG in 1148 patients (37.3%). At the same time, we performed in our units 2067 surgical procedures, out of which 1148 (55%) revascularizations by CABG. The angiographic control for patients with myocardial revascularization by stent (55 patients) or CABG (50 patients) was performed by clinical criteria (angina reappears) on 105 patients. The restenosis we found in 47 patients (74.5%) treated by stent revascularization and in 29 patients from CABG procedures. In our study restenosis rate was 4.8% in patients with PCI and 2.5% in patients with CABG. CONCLUSIONS: Both surgical (CABG) and percutaneous coronary artery revascularization (PCI) have proved to be extremely effective in the treatment of patients with multivessel coronary disease. In our study restenosis rate was smaller in the patients with CABG than in the PCI group, taking into account the fact that we did not use drug eluting stent (DES) on a large scale. Results from the series of randomized trials (SOS, SIRIUS, ERACI, ARTS, BARI, etc.) have shown that the restenosis phenomenon is an apparent advantage in patients with DES. Restenosis prevention is a complex phenomenon (inflammation, procoagulation, cellular migration, etc.) and DES appearance opens a new era in PCI.

Effect of short-term lithium carbonate administration in hyperthyroidism, with or without associated ophthalmopathy.

The study was carried out on 21 female hyperthyroid patients aged 22-53 years, with or without associated ophthalmopathy, admitted to the Endocrinology ward of the 1st Medical Clinic of the Craiova County Hospital, Romania, between 1983 and 1985. Administration of lithium carbonate was proceeded and followed by radioimmunoassay (RIA) determinations of T3 and T4 and measurement of Achilles' reflex (AR). Two regimens were employed. The first comprised ten patients receiving doses of 500 mg/day lithium carbonate and the second 11 patients who had an associated ophthalmopathy and who received 250 mg/day lithium carbonate and 30 mg/day carbimazole. Lithium administration was discontinued after 4 weeks. The results of the therapy suggest a possible intervention of lithium carbonate in the process of blocking the biosynthesis of thyroid hormones and/or its regulating processes, with concomitant improvement of the clinical status, much more in the patients without ophthalmopathy.