Pubmed du 02/12/18

dimanche 2 décembre 2018

1. Gray HL, Sinha S, Buro AW, Robinson C, Berkman K, Agazzi H, Shaffer-Hudkins E. Early History, Mealtime Environment, and Parental Views on Mealtime and Eating Behaviors among Children with ASD in Florida. Nutrients. 2018 ; 10(12).

This study was a cross-sectional study to examine problematic mealtime behaviors among children with autism spectrum disorder (ASD) in Florida. Forty-one parents completed a 48-item survey. The mean age of their children was 8.1 years and 73% were male. The data were divided and compared by age group : Ages 2(-)6, 7(-)11, and 12(-)17. Data from the 3- to 6-year-old children were extracted and compared with the references from Provost et al. (2010). There were age differences in eating difficulties at home (p = 0.013), fast food restaurants (p = 0.005), and at regular restaurants (p = 0.016). The total mealtime behavior score was significantly higher in early childhood (p < 0.001) and mid-childhood (p = 0.005) than adolescents. More parents of ages 3(-)6 with ASD reported difficulties with breastfeeding (p < 0.01) ; concerns about eating (p < 0.001) ; difficulties related to mealtime locations (p < 0.05), craving certain food (p < 0.05), and being picky eaters (p < 0.01) compared to typically developing children. The total mealtime behavior score was significantly higher in children with ASD than typically developing children (p < 0.001). The results indicate that early childhood interventions are warranted and further research in adolescents is needed.

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2. James BJ, Gales MA, Gales BJ. Bumetanide for Autism Spectrum Disorder in Children : A Review of Randomized Controlled Trials. The Annals of pharmacotherapy. 2018 : 1060028018817304.

OBJECTIVE : To evaluate clinical trials using bumetanide in autism spectrum disorder (ASD) treatment. DATA SOURCES : PubMed and Ovid MEDLINE (1946 to October 2018) were searched using terms bumetanide and autism. Bibliographies were reviewed for other relevant trials. STUDY SELECTION AND DATA EXTRACTION : English language, randomized, controlled, clinical trials in humans were evaluated. Three trials met all inclusion criteria. DATA SYNTHESIS : Oral bumetanide was studied in 208 patients, 2 to 18 years old, with ASD. Trials evaluated bumetanide’s impact on core behavioral features using several different autism assessment scales. All trials used the Childhood Autism Rating Scale to assess improvement at 90 days, with one trial finding statistical significance. The Clinical Global Impressions Scale identified statistically significant improvements in 2 of the 3 trials. The Autism Behavioral Checklist and Social Responsiveness Scales identified statistical benefit in the 2 trials utilizing those outcomes. Behaviors most improved by bumetanide included social communication, interactions, and restricted interest. No dose-effect correlation was identified in the dose-ranging trial. Adverse effects, including hypokalemia and polyuria, occurred more often with higher doses and resulted in withdrawal rates of 17% to 43%. Bumetanide 0.5 mg twice daily was the most studied and best tolerated dose. Limitations included unclear clinical success definitions and evaluation methodology variability. Relevance to Patient Care and Clinical Practice : No effective treatment options for core ASD symptoms have been approved. This review presents preliminary safety and efficacy data for bumetanide in ASD. CONCLUSIONS : Low-dose oral bumetanide may be useful in patients with moderate to severe ASD when behavioral therapies are not available.

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3. Singh D, Davis T. Fragile X-associated tremor ataxia syndrome and cognitive impairment. The Australian and New Zealand journal of psychiatry. 2018 : 4867418814942.

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4. Wachtel LE. Treatment of catatonia in autism spectrum disorders. Acta psychiatrica Scandinavica. 2018.

OBJECTIVE : To review the treatment courses of 22 autistic patients diagnosed with catatonia over a 12-year period, including treatment with benzodiazepines and electroconvulsive therapy. METHOD : Retrospective review of inpatient and outpatient records of 22 autistic youth presenting to a neurobehavioral service who were treated for catatonia. RESULTS : Six girls and 16 boys ranging from ages 8 to 26 years old presenting for neurobehavioral assessment were found to meet criteria for catatonia according to the DSM5 and were treated for such. All but one patient was initially unsuccessfully treated with benzodiazepines in dosages ranging from 1 to 27 mg daily, and all patients underwent electroconvulsive therapy. Mean age of ECT start was 15.6 years old, and the total number of ECT received ranged from 16 to 688, with 13 patients still receiving maintenance ECT at the end of the study period. ECT conferred prominent patient benefit in terms of catatonic symptom reduction, including alleviation of incapacitating, treatment-resistant self-injury. CONCLUSION : Myriad symptoms of catatonia were seen in this sample of 22 autistic youth. Implementation of anti-catatonic paradigms, particularly electroconvulsive therapy, conferred vast patient benefit.

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