Dyadic interactions in children exhibiting the broader autism phenotype: Is the broader autism phenotype distinguishable from typical development?

In families raising a child with an autism spectrum disorder (ASD), infant siblings are at elevated risk for ASD and other developmental concerns, including elements of the broader autism phenotype (BAP). Typically, the BAP is indexed using standardized developmental assessments; however, these measures do not capture a number of social difficulties commonly associated with the BAP. The present study aims to expand our developmental understanding of the BAP by comparing children exhibiting the BAP to their typically developing peers on, (a) standardized measures of development, and (b) social behaviors exhibited during dyadic play interactions. As part of a prospective study, dyads were recruited from families with at least one older child with ASD (high-risk, n = 36), and families with no history of ASD (low-risk, n = 38). During laboratory visits at 12, 15, 18, and 24 months of age, infants completed a series of standardized assessments and a mother-child play interaction. Dyadic play interactions were micro-analytically coded for gaze, positive affect, and vocalizations to create theory-driven composites to index dyadic synchrony and responsiveness. Videos were also coded with an existing rating scheme for joint engagement and child responsiveness. Multilevel models revealed significant group differences on select constructs within the first 2 years. Language and cognitive differences emerged by 24 months of age, whereas dyadic differences were evident as early as 15 months. Recognizing the increasing demand for elevated-risk interventions, these findings highlight several social constructs through which interventions may identify risk and promote optimal development. Autism Res 2019, 12: 469-481 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In families raising children with an autism spectrum disorder (ASD), younger siblings are at an increased risk for social and developmental difficulties that characterize a "broader autism phenotype." The present study explored the emergence of social, language, and cognitive differences in the first 2 years of life. Social differences were evident as early as 15 months of age for several play-based measures, and language and cognitive differences emerged by 24 months of age. For infant siblings of children with ASD, some of the earliest behavioral marks for subclinical features of ASD are evident within the first 2 years of life.

Autoría en la Revista de Otorrinolaringología y Cirugía de Cabeza y Cuello: análisis de tres décadas / Authorship in the Revista de Otorrinolaringología y Cirugía de Cabeza y Cuello: analysis of 3 decades

Background: The number of authors of scientific papers has increased significantly in the last decade. The increasing complexity of medical research but also vicious practices are possible causes of this trend. Aim: To analyze the number of authors and type of papers published in the Chilean Journal of Otorhinolaryngology and Head and Neck Surgery in the last three decades. Material and methods: A review of all manuscripts published between 1970 and 1999. The number of authors and the type of paper was registered. Results: Five hundred nineteen papers were reviewed. The mean number of authors per paper increased from 1.9 to 3 (p <0.001). Research reports decreased from 79 percent to 61 percent and the number of review articles and case reports increased. No multicentric work was published in the period. Conclusions: A significant increase in the number of authors per manuscript was observed in this review

Prolactina Y Prolactinomas: Una vision global / Prolactin and Prolactinomas: a global vision

La Prolactina es una hormona que está íntimamente ligada al eje gonadal y por lo tanto a la vida reproductiva de la mujer. Su regulación a través de dopamina, está relacionada con las gonadotropinas. Por lo tanto la hiperprolactinemia desde el punto de vista clínico se manifiesta con trastornos del ciclo, amenorrea e infertilidad. Por otra parte el prolactinoma, es la expresión final de la hiperplasia de las células lactotropas productoras de PRL en la hipófisis debido a la falla del mecanismo inhibitorio a través del cual se regula. El manejo del prolactinoma ha evolucionado de la cirugía transesfenoidal hasta el tratamiento médico con sustancias cada vez más efectivas y con menos efectos secundarios. La relación con el eje hipotálamo - hipófisis ovario, los mecanismos de acción hormonal, la historia natural del prolactinoma, el diagnóstico y el manejo de la hiperprolactinemia y los micro y macro prolactinomas se revisan con detalle

Caracterización fisicoquímica y biológica de la calidad de aguas de la cuenta de la quebrada Piedras Blancas, Antioquia, Colombia / Physcochemical and biological characterization of water quality in the Piedras Blancas basin, Antioquia, Colombia

From April to December 1996 a limnological study was carried out in 17 streams near Medellín, in order to stablish their water quality. The area is located in Piedras Blancas Park (6§8`20``N, 75§30`20``W)SE of Medellín at 2400m altitude. Three sampling periods, encompasing wet and dry season were selected. April-May, August-September and October-December. For qualitative collection methods hand screen and D-net were used. Each station was intensively sampled to collect most macroinvertebrates in all types of habitat. The area sampled in each station was 6m2. Physicochemical variables ingeneral showed small fluctuations along the study; only conductivity and total dissolved solids exhibited significant changes, all related with high precipitation in the west season. Macroinvertebrate community consisted of 113 genera, 63 families and seven phyla. Trichoptera was the most abundant group. The results indicate that the freshwater ecosystems in the study area present a high water quality corresponding to a oligo-metrophic system. Key words: Aquatic ecology, tropical limnology, tropical macroinvertebrates

Maternal care and attachment security in ordinary and emergency contexts.

One of the foundations of attachment theory is the notion that early care plays a key role in determining the quality of child-caregiver attachment relationships. Studies have consistently shown relations between maternal sensitivity and infant security. Further research is required to resolve issues arising from modest correlations, focus on research in stressful as opposed to ordinary contexts, and questions about the generality of results across cultures and social contexts and about the context specificity of caregiving behavior. This article addressed these issues in 2 studies of child care in home and hospital contexts. Q-sort scores derived from extended naturalistic observations were used. Results are discussed in terms of links between methodology and effect sizes, the generality of links between maternal care and child security, the need for further research on caregiving in ordinary and emergency situations, and the context sensitivity of maternal behavior.

The development of attachment: from control system to working models.

After two decades of theoretical and descriptive work, we know a great deal about the developmental course of early attachment relationships. We know considerably less about the mechanisms underlying consistency and change. Indeed, the most pressing issue in attachment theory is to explain well-replicated correlations between early care and subsequent patterns of secure base behavior, and between secure base behavior in infancy and subsequent behavior with parents and siblings, social competence, self-esteem, and behavior problems. As a step in this direction, we examine Bowlby's developmental outline, with an eye toward providing greater detail and incorporating traditional learning mechanisms into Bowlby's attachment theory.

Rice-based oral electrolyte solutions for the management of infantile diarrhea.

BACKGROUND: In infants the treatment of acute diarrhea with glucose-based solutions results in rehydration but does not reduce the severity of diarrhea. Oral rehydration with solutions based on rice powder may reduce stool output as well as restore fluid volume. METHODS: We designed a prospective, randomized, double-blind study to evaluate the efficacy of two rice-based rehydration solutions and a conventional glucose-based solution. Solution A contained only rice-syrup solids, solution B contained rice-syrup solids and casein hydrolysate, and solution C, the glucose-based solution, served as control. The study subjects were 86 mildly to moderately dehydrated infant boys, 3 to 18 months old, who were admitted to a children's hospital with acute diarrhea. We measured fluid intake, fecal and urine output, and absorption and retention of fluid, sodium, and potassium at intervals for 48 hours in all 86 infants. RESULTS: The mean (+/- SE) fecal output was significantly lower in the infants given solution A (group A infants) than in the infants given solution C (group C) (29 +/- 4 vs. 46 +/- 7 ml per kilogram of body weight, P less than 0.05) during the first six hours of therapy. The infants in group A also had greater fluid absorption (221 +/- 16 vs. 167 +/- 9 ml per kilogram, P less than 0.05) over the entire 48 hours of therapy and greater potassium absorption (1.6 +/- 0.2 vs. 0.6 +/- 0.1 mmol per kilogram, P less than 0.05) during the first six hours than the infants in group C. Solution B offered no advantages over solution A. CONCLUSIONS: Solutions containing rice-syrup solids were effective in the rehydration of infants with acute diarrhea. They decreased stool output and promoted greater absorption and retention of fluid and electrolytes than did a glucose-based solution.

Comparison of cattle of a five-breed diallel: size, growth, condition and pubertal characters of second-generation heifers.

Monthly weights, heights and condition scores and measurements taken at the time of puberty were utilized to estimate effects of breed-type and heterosis on characters related to growth, size and puberty of second-generation heifers of a five-breed diallel involving Angus, Brahman, Hereford, Holstein and Jersey. One group of heifers was maintained on pasture with supplemental feed; two other groups were fed in individual pens starting at weaning and 1 yr of age, respectively. A model including main effects of breed-type, sire within breed-type, management, parity of dam and birth-season was used for analyzing all characters. Breed-type tested with sire within breed-type was significant for all characters except ADG from 360 to 450 d. Straightbred and crossbred means were larger for the second generation than for the first, presumably due to management and(or) year effects. Heterosis generally was positive and, when expressed as a percentage, decreased with age, which is in agreement with other research reports. Holsteins and Brahmans were largest for growth and size characters, whereas Jerseys were smallest. Jerseys were the youngest, lightest and shortest at puberty, whereas Brahmans were oldest, heaviest and tallest.

Comparison of efficacy of a glucose/glycine/glycylglycine electrolyte solution versus the standard WHO/ORS in diarrheic dehydrated children.

It was hypothesized that a mixture of glucose and amino acids enhances sodium and water absorption and therefore diminishes the volume of oral rehydration solution, stool output, and duration of diarrhea. To investigate this hypothesis, the efficacies of two oral rehydration solutions (ORS) were compared, one containing (mmol/L): Na+ 90, K+ 20, Cl- 80, citrate 10, glucose 67, glycine 53, and glycylglycine 30, yielding an osmolality of 350 mosmol/kg H2O, and the other, the standard ORS recommended by the World Health Organization, containing the same electrolyte concentrations and only glucose 110 mmol/L, yielding 310 mosmol/kg H2O. The study group comprised 31 infants and small children for group A (receiving solution A, the glucose/glycine/glycylglycine-based ORS) and 31 patients for group B (receiving solution B, the standard WHO/ORS). There were no significant differences between the groups in age, fluid loss, or dehydration, or between the groups with respect to clinical outcome, mean time to achieve rehydration, mean percent body weight gain, and serum electrolyte composition. The only statistically significant difference was the mean time between admission and the last diarrheic stool. The glycylglycine/glycine/glucose electrolyte solution was found to be suitable for rehydration, but not to have an advantage over the standard WHO/ORS.

PIP: A study was carried out on 62 male infant children, aged 3-24 months in San Jose, Puerto Rico. The purpose of the study was to discover if a mixture of glucose and amino acids enhances sodium and water absorption, thereby diminishing the volume of oral rehydration solution, stool output and duration of diarrhea. To investigate this hypothesis, the efficacies of two oral rehydration solutions (ORT) were compared: the ORT recommended by WHO (mmol/L) Na + 90, K + 20, C1- 80 Citrate 10, Glucose 110, yielding an osmolality of 310 (mosmol/kg H20) and one containing (mmol/L): Na+ 90, K+ 20, C1-80, Citrate 10, Glucose 67, Glycine 53, Glycylglycine 30, and yielding an osmolality of 350 (mosmol/kg H2)). Results are as follows: the infants were divided into two groups - A and B - with each consisting of 31 males per group; group A received the glycine based solution while group B received the WHO/ORS. There was no significant difference in: the mean age of the patients, mean time and mean number of vomiting, duration of diarrhea, number of stool motions, and duration of fever before admission between the two groups. The glycylglycine/glycine/ glucose electrolyte solution was found to be suitable for rehydration, but is not superior to the standard WHO/ORS. The glycine solution resulted in shortening the duration of diarrheal illness, but failed to decrease the ingested amount of ORS as well as the stool output volume.

Hypernatremic diarrheal dehydration treated with oral glucose-electrolyte solution containing 90 or 75 mEq/L of sodium.

Of 33 infants with hypernatremic dehydration (serum Na+ of greater than or equal to 150 mEq/L) 7 were excluded, 6 because severe alteration of the level of consciousness or shock precluded oral rehydration and 1 because he was given glucose-electrolyte solution plus water. We studied the remaining 27 infants. Twenty (group A) were treated with the World Health Organization-recommended oral rehydration solution (90 mEq/L Na+) and seven (group B) were treated with Pedialyte-RS (Abbott Laboratories Ltd.; 75 mEq/L Na+). The rehydrating solutions were administered in a volume equivalent to twice the clinically estimated fluid deficit. Initial serum sodium was 156.7 +/- 0.9 mEq/L for group A and 155.8 +/- 1.8 mEq/L for group B (mean +/- SEM). The mean time to achieve rehydration was 14.3 and 16.6 h for groups A and B, respectively. Twenty-four hours after commencing oral rehydration, serum Na+ had decreased to 144.8 +/- 1.8 mEq/L for group A and 144.5 +/- 0.9 mEq/L for group B. In two patients in group A, the serum Na+, which, had not decreased to less than 150 mEq/L at 24 h, did so at 48 h. Only in one case (group A) did the serum Na+ increase. This patient had high stool output and failed to become rehydrated after 24 h of unsuccessful oral rehydration. None of the patients had seizures or persistent CNS dysfunction. We conclude that the slow administration of oral rehydration solutions containing either 90 or 75 mEq/L Na+ is a safe and effective treatment of hypernatremic dehydration.

Comparison of glucose/electrolyte and glucose/glycine/electrolyte oral rehydration solutions in hospitalized children with diarrhea in Costa Rica.

The experience of Nalin et al. and Patra et al. with a "super oral rehydration solution (ORS)" containing glucose plus glycine to enhance the intestinal absorption of sodium and water prompted us to investigate a similar ORS containing the standard World Health Organization (WHO/ORS) plus either 55 or 110 mmol/L glycine in infants and small children with noncholera diarrhea. We did not find a statistically significant difference between the glycine-fortified ORS and the standard WHO/ORS with respect to the clinical outcome and composition of serum electrolytes.

PIP: Oral rehydration solutions containing the WHO recommended mixture alone, or with 111 mmol/L glycine or 55 mmol/L glycine were compared for treatment of 30 male children aged 1-24 months with clinical diarrheal dehydration in the emergency room of the National Children's Hospital, San Jose, Costa Rica. ORS volume was estimated by doubling the degree of dehydration judged clinically, offered by teaspoons over 4 hours. Children that could not tolerate oral solution were given ORS by nasogastric tube. Those with hypokalemia 3 mmol/L were given a solution containing 20 mmol/L K+ or iv fluid. The time to rehydration averaged 9.45 hours with the WHO solution, 10.2 hours with the low glycine ORS and 8.95 with the high glycine ORS (n.s.). Percent body weight gain did not differ significantly. The average stool weight and urine excretion were lower in the high glycine group, not significantly. 3 children developed mild hypernatremia, but normalized without additional treatment. Thus, glycine-fortified ORS made no significant difference in clinical outcome or serum electrolytes in this series.

Efficacy comparison of oral rehydration solutions containing either 90 or 75 millimoles of sodium per liter.

In a randomized trial, 62 infants 2 to 35 months of age with dehydration due to acute watery diarrhea were allocated to one of two groups: group A received solution A (World Health Organization-recommended oral rehydration solution), which contained (mmol/L): Na+ 90, K+ 20, Cl- 80, citrate3- 10, and glucose 110; group B received solution B (Pedialyte RS; Abbott Laboratories, North Chicago), which contained (in mmol/L): Na+ 75, K+ 20, Cl- 65, citrate3- 10, and glucose 139. Oral therapy was given until clinical signs of hydration status were normal. During the 48-hour trial, the following laboratory data were collected: blood gases, serum electrolytes, glucose, urea, and creatinine values and sodium and potassium concentrations in stool and urine; serial weights and clinical signs were also reported. Six of the 62 infants, three in each group, required intravenous fluids because of high stool output. Results of clinical outcome and normalization of altered serum electrolyte values were similar in both groups. During the 48-hour trial, eight patients in group A and four in group B had mild, asymptomatic hypernatremia. Pedialyte RS was found to be a safe glucose/electrolyte solution for oral rehydration therapy.