ABSTRACT
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressants used to preclude maternal pregnancy depression. There is a growing body of literature assessing the association of prenatal exposure to SSRIs with autism spectrum disorder (ASD). The present systematic review and meta-analysis reviewed the medical literature and pooled the results of the association of prenatal exposure to SSRIs with ASD. METHODS: Published investigations in English by June 2016 with keywords of selective serotonin reuptake inhibitors, SSRI, autism spectrum disorder, ASD, pregnancy, childhood, children, neurodevelopment were identified using databases PubMed and PMC, MEDLINE, EMBASE, SCOPUS, and Google Scholar. Cochran's Q statistic-value (Q), degree of freedom (df), and I2 indices (variation in odds ratio [OR] attributable to heterogeneity) were calculated to analyze the risk of heterogeneity of the within- and between-study variability. Pooled odds ratio (OR) and 95% confidence interval (CI) were reported by a Mantel-Haenszel test. RESULTS: There was a non-significant heterogeneity for the included studies ([Q=3.61, df=6, P=0.730], I2=0%). The pooled results showed a significant association between prenatal SSRI exposure and ASD (OR=1.82, 95% CI=1.59-2.10, Z=8.49, P=0.00). CONCLUSION: The evidence from the present study suggests that prenatal exposure to SSRIs is associated with a higher risk of ASD.
Subject(s)
Antidepressive Agents/adverse effects , Autism Spectrum Disorder/etiology , Depressive Disorder/drug therapy , Pregnancy Complications/drug therapy , Selective Serotonin Reuptake Inhibitors/adverse effects , Antidepressive Agents/therapeutic use , Child , Depression , Female , Humans , Male , Pregnancy , Prenatal Exposure Delayed Effects , Selective Serotonin Reuptake Inhibitors/therapeutic useABSTRACT
The aim of present study was to investigate clinical, electrodiagnostic and pedobarographic findings of non-amputee limb in chronic leprotic patients with unilateral trans-tibial amputation to determine neuropathy and plantar foot pressure in non-amputee limb. During the present prospective cross-sectional study, 10 chronic leprotic patients with unilateral trans-tibial amputation were evaluated. The study was conducted in Tabriz Bababaghi and Imam Reza Hospitals at summer of 2008. Sensory nerve conduction (SNAP) and Compound Motor Action Potentials (CMAP) studies were performed in association with pedobarographic assessment. No reliable response was detected from tested sensory and motor nerves, except a very low amplitude finding in deep preoneal nerve of one patient. In comparing with healthy group, static total plantar area, dynamic total plantar area, static rarefoot peak pressure and dynamic rarefoot peak pressure were lower in leprotic patients (p = 0.047, p = 0.004, p = 0.029 and p < 0.001), while static forefoot peak pressure and dynamic forefoot peak pressure were higher in these patients (p = 0.011 and p = 0.031). All of leprotic patients with unilateral trans-tibial amputation suffered from severe neuropathy. Also, these patients have high plantar pressure under the forefoot. Collectively, severe neuropathy and abnormal plantar foot pressure expose in non-amputee foot expose leprotic patients to the higher risk of secondary amputation.
Subject(s)
Amputation, Surgical , Electrodiagnosis , Forefoot, Human , Leprosy , Tibia/surgery , Aged , Cross-Sectional Studies , Female , Forefoot, Human/anatomy & histology , Forefoot, Human/physiology , Humans , Leprosy/pathology , Leprosy/physiopathology , Leprosy/surgery , Male , Middle Aged , Pressure , Prospective StudiesABSTRACT
To determine possible predictors of FIM scores in patients with hip fracture at discharge a prospective cohort study of 117 patients with either DHS or hip arthroplasty admitted to a rehabilitation service was done. They were classified into four subgroups of underweight (BMI < 18.5), normal (18.5 < BMI < 24.9), overweight (25 < BMI < 29.9) and obese (30 < BMI < 35). Functional evaluations using FIM score as well as sitting, standing, walking days and length of stay for each patient were assessed by a highly skilled therapist at rehabilitation admission; discharge and a post discharge follow up. Recovery was significant in terms of motor subscale. No significant correlation was evident between hospitalization and discharge time with respect to cognitive subscale. The study showed only the age and FIM score at hospitalization to be the independent predictors of total FIM score at discharge. Elevated BMI has not adverse effect on FIM gains in patients with hip fractures. Simple surgery methods such as DHS revealed earlier recovery time than complicated procedures.
