Effect of α-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy.

Objective To examine the effect of α-lipoic acid on neuropathic symptoms in patients with diabetic neuropathy (DN). Methods Patients with painful DN were treated with 600 mg/day α-lipoic acid, orally, for 40 days. Neuropathy Symptom Score (NSS), Subjective Peripheral Neuropathy Screen Questionnaire (SPNSQ) and douleur neuropathique (DN)4 questionnaire scores were assessed at baseline and day 40. Quality-of-life treatment effects were assessed by Brief Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI) and Sheehan Disability Scale (SDS). Changes in body weight, arterial blood pressure, fasting serum glucose and lipids were also assessed. Results Out of 72 patients included, significant reductions in neuropathic symptoms were shown by reduced NSS, SPNSQ and DN4 scores at day 40 versus baseline. BPI, NPSI, and SDS in terms of work disability, social life disability, and family life disability scores were also significantly reduced. Moreover, 50% of patients rated their health condition as 'very much better' or 'much better' following α-lipoic acid administration. Fasting triglyceride levels were reduced, but no difference was found in body weight, blood pressure, fasting glucose, or other lipids at day 40 versus baseline. Conclusions A-lipoic acid administration was associated with reduced neuropathic symptoms and triglycerides, and improved quality of life.

The impact on the family of the co-existing conditions of children with autism spectrum disorder.

We aimed to investigate whether the impact on families of children with Autism Spectrum Disorder (ASD) is associated with the number and/or type of emotional and behavioral co-existing conditions that parents/carers of children with ASD reported as occurring frequently. In addition, we examined whether there was a greater impact on families if their child was male, had lower levels of language, had more severe autism symptomatology, and whether impact was associated with the number and/or type of co-existing conditions. Families were recruited from large UK research databases. 420 parents/carers of children aged 3 years 2 months to 18 years 8 months completed the revised Impact on Family (IoF) Scale and reported on the frequency/rate of their child's co-existing conditions. Parents/carers reported higher mean IoF scores if their child: had a greater number of frequent co-existing conditions; had sleep problems; was only able to communicate physically; and had more severe autism symptomatology. The development and implementation of targeted treatment and management approaches are needed to reduce the impact of co-existing conditions on family life. Autism Res 2018, 11: 776-787. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Autism Spectrum Disorder (ASD) is commonly associated with emotional and/or behavior conditions that affect family life. Parents/carers of children with ASD who: (a) reported a greater number of frequent co-existing conditions, (b) had sleep problems, (c) were only able to communicate physically, and (d) had more severe symptoms characteristic of autism, reported a greater burden/strain on the family. Treatment approaches to target co-existing conditions alongside characteristics of ASD are needed to reduce their impact on family life.

Categorical Speech Perception in Adults with Autism Spectrum Conditions.

This study tested whether individuals with autism spectrum conditions (n = 23) show enhanced discrimination of acoustic differences that signal a linguistic contrast (i.e., /g/ versus /k/ as in 'goat' and 'coat') and whether they process such differences in a less categorical fashion as compared with 23 IQ-matched typically developed adults. Tasks administered were nonverbal IQ, verbal IQ, 5 language measures, a speech perception task, and the ADOS. The speech perception task measured the discrimination of paired exemplars along the /g/-/k/ continuum. Individuals with autism spectrum conditions did not show enhanced discrimination of speech perception. Categorical speech perception was correlated with verbal ability of reading, lexical decision, and verbal IQ in individuals with autism spectrum conditions.

A trial of an iPad™ intervention targeting social communication skills in children with autism.

This study evaluated a technology-based early intervention for social communication skills in pre-schoolers in a randomised controlled trial. Participants were 54 children aged under 6 years with a diagnosis of autism, assigned to either intervention or control conditions. The app engaged children, who played consistently, regardless of developmental level, and was rated highly by parents. There were no significant group differences in parent-report measures post-intervention, nor in a measure of parent-child play at follow-up. Therefore, this intervention did not have an observable impact on real-world social communication skills and caution is recommended about the potential usefulness of iPad(™) apps for amelioration of difficulties in interaction. However, positive attitudes among participants, lack of harms and the potential of apps to deliver therapeutic content at low economic cost suggest this approach is worth pursuing further, perhaps targeting other skill domains.

Lexical effects on children's speech processing: individual differences reflected in the Autism-Spectrum Quotient (AQ).

PURPOSE: This study was undertaken to examine whether children exhibit the same relationship that adults show between lexical influence on phoneme identification and individual variation on the Autism-Spectrum Quotient (AQ). METHOD: Data from 62 4- to 7-year-olds with no diagnosis of autism were analyzed. The main task involved identification of the initial sound in pairs of voice-onset time continua with a real word on one end and a nonword on the other (e.g., gift-kift, giss-kiss). Participants were also given the children's version of the AQ and a 2nd instrument related to autistic-like traits, the Social Responsiveness Scale (SRS). RESULTS: The lexical shift was related to the AQ (particularly to its Attention Switching subscale) but not to the SRS. CONCLUSIONS: The size of lexical effects on children's speech perception can be predicted by AQ scores but not necessarily by other measures of autism-like traits. The results indicate that speech perception in children manifests individual differences along some general dimension of cognitive style reflected in the AQ, possibly in relation to local/global information processing.

Surgical management of cardiac implantable electronic device infections.

PURPOSE: The infection of cardiac implantable electronic devices (CIED) is a serious and potentially lethal complication. The population at risk is growing, as the device implantation is increasing especially in older patients with associated comorbid conditions. Our purpose was to present the management of this complicated surgical condition and to extract the relevant conclusions. METHODS: During a 3-year period 1,508 CIED were implanted in our hospital. We treated six cases of permanent pacemaker infection with localized pocket infection or endocarditis. In accordance to the recent AHA/ACC guidelines, complete device removal was decided in all cases. The devices were removed under general anaesthesia, with a midline sternotomy, under extracorporeal circulation on the beating heart. Epicardial permanent pacing electrodes were placed on the right atrium and ventricle before the end of the procedure. RESULTS: The postoperative course of all patients was uncomplicated and after a follow up period of five years no relapse of infection occurred. CONCLUSIONS: Management protocols that include complete device removal are the only effective measure for the eradication of CIED infections. Although newer technologies have emerged and specialized techniques of percutaneous device removal have been developed, the surgical alternative to these methods can be a safe solution in cases of infected devices.

Reversible dilated cardiomyopathy associated with amphotericin B treatment.

We report two patients, who developed dilated cardiomyopathy and subsequent congestive heart failure after treatment with amphotericin B (AmB). The echocardiographic findings and the symptoms of heart failure resolved after the discontinuation of the drug. The clinical data from our cases and two similar cases reported in the literature suggest that the presence of other factors predisposing to cardiac dysfunction may facilitate the occurrence of this rare side effect.