Pubmed du 08/04/18

dimanche 8 avril 2018

1. Andrews DS, Marquand A, Ecker C, McAlonan G. Using Pattern Classification to Identify Brain Imaging Markers in Autism Spectrum Disorder. Current topics in behavioral neurosciences. 2018.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social interaction and communication, as well as repetitive and restrictive behaviours. The etiological and phenotypic complexity of ASD has so far hindered the development of clinically useful biomarkers for the condition. Neuroimaging studies have been valuable in establishing a biological basis for ASD. Increasingly, neuroimaging has been combined with ’machine learning’-based pattern classification methods to make individual diagnostic predictions. Moving forward, the hope is that these techniques may not only facilitate the diagnostic process but may also aid in fractionating the ASD phenotype into more biologically homogeneous sub-groups, with defined pathophysiology, predictable outcomes and/or responses to targeted treatments and/or interventions. This review chapter will first introduce ’machine learning’ and pattern recognition methods in general, with a focus on their application to diagnostic classification. It will highlight why such approaches to biomarker discovery may have advantages over more conventional analytical methods. Magnetic resonance imaging (MRI) findings of atypical brain structure, function and connectivity in ASD will be briefly reviewed before we describe how pattern recognition has been applied to generate predictive models for ASD. Last, we will discuss some limitations and pitfalls of pattern recognition analyses in ASD and consider how the field can advance beyond the prediction of binary outcomes.

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2. Hirose K, Miwa S, Sakaguchi H, Takimoto S, Yoshida Y, Onga Y, Tara Y, Yamanaka K. Re-Expansion Pulmonary Edema After ASD Closure Through Right-Sided Mini-Thoracotomy. The Annals of thoracic surgery. 2018.

We described a case suffering from re-expanded pulmonary edema (RPE) after atrial septal defect (ASD) closure through right-sided mini-thoracotomy. After re-expansion of the right lung after weaning from cardiopulmonary bypass (CPB), a large amount of serous slight-hemorrhagic bronchial secretions spilled out from the right bronchus. Positive pressure ventilation and differential ventilation were used. We found no bleeding and decreased secretions 24 hours after the onset of RPE. She was extubated 42 hours after the operation. To the best of our knowledge, the current case is the first to report the development of RPE during routine minimally invasive surgery for ASD.

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3. Jia F, Shan L, Wang B, Li H, Feng J, Xu Z, Saad K. Fluctuations in clinical symptoms with changes in serum 25(OH) vitamin D levels in autistic children : Three cases report. Nutr Neurosci. 2018 : 1-4.

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder caused by complicated interactions between genetic and environmental factors. Clinical trials, including case reports, case-control studies, and a double-blinded randomized clinical study, have suggested that high-dose vitamin D3 regimens may ameliorate the core symptoms of ASD. Vitamin D3 supplementation was effective in about three-quarters of children with ASD. To further investigate the relationship between vitamin D and ASD symptoms in vitamin D-responsive autistic children, changes in symptoms were assessed in three children with ASD who were given vitamin D3 supplementation followed by a long interruption. The core symptoms of ASD were remarkably improved during the vitamin D3 supplementation period when serum 25-hydroxyvitamin D [25(OH)]D levels reached over 40.0 ng/mL. However, symptoms reappeared after the supplementation was stopped, when serum 25(OH)D levels fell below 30.0 ng/mL but were again improved with re-administration of vitamin D3 after the interruption, when serum 25(OH)D levels exceeded 40.0 ng/mL. Overall, these results showed that the core symptoms of ASD fluctuated in severity with changes in serum 25(OH)D levels in children, indicating that maintaining a responsive 25(OH)D level is important for treating ASD. Maintaining a serum 25(OH)D level between 40.0 and 100.0 ng/ml may be optimal for producing therapeutic effects in vitamin D-responsive individuals with ASD.

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4. Mintz ME. A parent-centered approach to autism diagnosis in early childhood. World journal of pediatrics : WJP. 2018.

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5. Stavropoulos KK, Bolourian Y, Blacher J. Differential Diagnosis of Autism Spectrum Disorder and Post Traumatic Stress Disorder : Two Clinical Cases. J Clin Med. 2018 ; 7(4).

Autism spectrum disorder (ASD) is estimated to affect one in 68 children. Given the increase in both prevalence and awareness of ASD, it is critical to provide accurate and timely diagnosis. However, ASD often co-occurs with other disorders, making diagnosis difficult. The objective of the current case study was to provide two examples of differential diagnosis in ASD and post-traumatic stress disorder (PTSD) observed in an autism clinic. In both cases, the goal was to decide whether each child should be given a diagnosis of ASD, PTSD, or both.

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