Category: medicine

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Children’s of Alabama Expands Sensory Pathway For Patients With Sensory Sensitivities

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When Sladen Fisher got a bad cut on his earlobe at school, his mother, Jennifer Fisher, worried the sights and sounds of Children’s of Alabama’s Emergency Department would be too stressful for her son. That’s because Sladen has attention deficit hyperactivity disorder (ADHD) and sensory processing disorder.

At the time of the Sladen’s visit, Children’s of Alabama had just launched its Sensory Pathway, designed for patients with conditions such as ADHD, autism and Down syndrome. In 2016, the pathway began as a pilot project in the Emergency Department; however, it has since expanded to One Day Surgery and several inpatient units at Children’s of Alabama, including the Pediatric Intensive Care Unit, Pulmonary Care Unit and Special Care Unit. Future plans include expansion to ancillary and outpatient services.

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The pathway made a lasting impact on Sladen. Back at school a few weeks later, he presented a report about someone he considers a hero. He chose Children’s of Alabama Child Life Specialist Shelby Smith, who stayed by his side during his visit, explained his treatment in terms he understood and provided him with an iPad and fidget toys for distraction and comfort.

“In his mind, she was a hero, someone who went above and beyond to help him,” Jennifer said. She made what could have been an incredibly difficult situation so amazing. She really was our hero.”The pathway has been equally impactful on Children’s of Alabama, said Michele Kong, M.D. associate professor in pediatric critical care at the University of Alabama at Birmingham (UAB) Department of Pediatrics.

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“The pathway has been so empowering for our providers,” said Kong, who serves on the Sensory Pathway Task Force, also comprised of nurses, informatics specialists and child life specialists. Unit by unit, the task force provides education and training and is developing an online training module. The task force is also working with information technology specialists to flag patients with sensory sensitivities from the point of admission.

“We tailor education and training to suit each unit’s needs because each unit’s workflow and culture is different,” Kong said. “The success of the pathway is a direct reflection of our providers’ passion to learn. There’s buy-in from our providers because they know it’s good for their patients.”

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As a parent, Kong, too, knows how jarring a hospital visit can be for a child with sensory sensitivities. Her oldest son, Abram, was diagnosed with autism at age 4. The diagnosis inspired Kong and her husband, Julian Maha, M.D., to found KultureCity®, a nonprofit that works to “create acceptance and inclusion for all individuals with unique abilities,” according to its mission statement. In 2019, KultureCity was ranked fourth on Fast Company magazine’s list of the most innovative companies in the world. KultureCity not only partners with local organizations in Birmingham, but also with national organizations such as the NBA and NFL.

“We never imagined it would reach this scale,” Kong said. “It impressed on us that there’s a lot of power when a collective group of people have the same belief and passion for change.”

HPV Vaccine: 7 Myths and Facts You Need to Know

Nuvance Health physician dispels common misconceptions about the HPV vaccine and discusses its role in protecting against HPV-related diseases

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January is Cervical Health Awareness Month

By Dr. Linus Chuang, Chair of Obstetrics and Gynecology, Nuvance Health

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Summary:

  • A vaccine is available to protect against human papillomavirus (HPV). HPV is the most common sexually transmitted infection and can cause diseases such as genital warts and cancer.
  • The HPV vaccine now protects against nine strains of HPV. Research shows that the HPV vaccine is safe and effective.
  • The HPV vaccine is approved for men and women between the ages of 9 to 45. The HPV vaccine can protect adults from HPV-related diseases, however it provides the most protection when it is given in childhood before someone becomes sexually active.
  • Parents should talk with their child’s pediatrician about the HPV vaccine. Adult men should ask their primary care provider about the HPV vaccine, and adult women should speak with their gynecologist.
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In 2006, the U.S. Food and Drug Administration (FDA) approved Gardasil, a vaccine to prevent diseases such as cancer and genital warts that are caused by human papillomavirus (HPV). Within the last five years, improvements have been made to the HPV vaccine and the recommended age range for administration has been expanded, resulting in more robust HPV protection being available to more people.

Although the HPV vaccine has proven to be highly effective at preventing HPV-related diseases and cancers, misconceptions still exist about how it works, who should receive it, and whether it is safe. Here are seven myths about HPV and the HPV vaccine and also the facts you need to know.

Myth #1: I/my child won’t contract HPV.
Fact: HPV is the most common sexually transmitted infection.

Most sexually active people will contract HPV. The U.S. Centers for Disease Control and Prevention (CDC) estimates that nearly 80 million people — or 1 in 4 Americans — are infected with HPV. The CDC further estimates that about 14 million people, including teens, will contract a new HPV infection each year.

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Myth #2: Having HPV doesn’t mean I/my child will get cancer.
Fact: Having HPV increases cancer risk — and HPV-related cancers are on the rise.

According to the CDC, more than 43,000 people developed HPV-associated cancer in 2015, up from 30,000 people in 1999. The HPV vaccine can prevent most types of HPV-related cancers, including anal, cervical, penile, throat, and vaginal cancers.

Myth #3: The HPV vaccine is only for women.
Fact: Men and women should get the HPV vaccine.

HPV affects both men and women. HPV can cause genital warts and anal and oral cancers in both men and women. It can also cause cervical or vaginal cancers in women and penile cancers in men. Because HPV often does not cause symptoms right away and many people are unaware that they have it, it can easily and unknowingly be transmitted to a sex partner.

Myth #4: The HPV vaccine isn’t effective.
Fact: The newest vaccine is effective against nine strains of HPV.

When Gardasil, the original HPV vaccine, was first approved by the FDA in 2006, it only protected against four types of HPV. In 2014, the FDA approved a new vaccine called Gardasil 9 that protects against the same four types of HPV, plus an additional five types.

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Research also shows that the HPV vaccine provided nearly 100 percent protection against persistent cervical infections with HPV types 16 and 18, plus the pre-cancers caused by those persistent infections.

Myth #5: The HPV vaccine is only for children and young adults.
Fact: Children and adults ages 9 to 45 can now get the HPV vaccine.

Gardasil and Gardasil 9 were originally approved for boys and girls ages 9 to 26. In 2018, the FDA expanded the age range for Gardasil 9 to include men and women ages 27 to 45. This expanded approval provides more opportunity to prevent HPV-related diseases and cancers in a broader age range.

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Although the HPV vaccine is most effective when it is given before someone becomes sexually active — ideally in childhood — there is now data that suggests that the vaccine also can benefit adults. Statistics show that many sexually active adults have been exposed to some types of HPV, but most have not been exposed to all nine types covered by the newest vaccine. Even if an adult already has HPV, the vaccine may still help to reduce the risk of developing HPV-related diseases.

Myth #6: The HPV vaccine isn’t safe.
Fact: Extensive testing and research show that the HPV vaccine is safe.

The FDA closely monitors the safety and effectiveness of all vaccines before and after approval, and research shows that the HPV vaccine is safe. However, like any other vaccine or medication, some people may experience mild reactions or side effects to the HPV vaccine, such as fever, dizziness, fatigue, or pain, redness, or swelling at the injection site.

Myth #7: The HPV vaccine encourages sexual promiscuity.
Fact: Research has shown no link between being vaccinated for HPV and an increase in sexual activity.

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Recent research that included 500,000 individuals found that there was no increase in sexual activity after HPV vaccination. Additionally, the research showed that participants who received the HPV vaccine actually engaged in safer sexual practices than unvaccinated participants.

The bottom line: The HPV vaccine is a safe and effective way to reduce your risk (or your child’s risk) of developing an HPV-related health problem. Parents should ask their child’s pediatrician about the HPV vaccine — ideally before the child becomes sexually active. Adult men should speak with their primary care provider about the HPV vaccine, and adult women should talk with their gynecologist.

About Dr. Linus Chuang

Dr. Linus Chuang is the chair of OB/GYN at Nuvance Health’s Danbury Hospital and Norwalk Hospital. He is a global gynecologic oncology expert and the American Society of Clinical Oncology’s (ASCO) International Affairs Committee Chair. Dr. Chuang has been recognized as an American Cancer Society (ACS) HPV Champion. He is passionate about educating people about the benefits of HPV vaccination and its role in preventing cancer and other HPV-related diseases.

How Healthy is Chicken Noodle Soup?

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You may remember a loved one making you a bowl of chicken noodle soup whenever you were feeling under the weather as a child. Just how healthy is this culinary cure-all?

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“Studies have shown that a hearty bowl of chicken noodle soup may help clear nasal congestion and ease cold symptoms,” says BIDMC clinical dietitian Sandy Allonen, RD. “It’s all about the ingredients.”

So let’s break it down – what’s in your soup?

Broth

If you’re fighting a cold, your doctor will tell you it’s important to stay hydrated. “A clear broth is warm and soothing, making it a great source of hydration while you’re sick, especially if you have a sore throat,” Allonen says.

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Whether it’s vegetable or chicken broth – Allonen says the benefits are similar. “You may think added salt and other seasonings aren’t great for you, but in moderation, these spices can help combat the feeling of dull taste buds,” she says. “A loss of taste is common in a cold, but as with any flavor enhancer, salt is great for getting you to eat more.”

Allonen notes, however, that if your doctor has recommended you limit your sodium intake (whether this be for hypertension, kidney disease, congestive heart failure or another medical condition), then you will want to look for a broth that is low sodium or has no added salt.

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Chicken

Chicken is full of protein that helps support the immune system. It’s also a good source of vitamins and minerals, such as B vitamins, which boost immunity and help regulate digestion.

“Chicken is also high in tryptophan, which helps your body produce serotonin that can enhance your mood and give you the feeling of ‘comfort’ that helps make chicken noodle soup a true comfort food,” Allonen says.

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Noodles

The noodles in chicken noodle soup aren’t just for show. They’re packed with carbohydrates that help you feel full and satisfied.

“Carbs are the preferred source of energy for your body, so getting in a good dose through soup can help you feel less sluggish,” Allonen says.

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Vegetables

All those bits of carrot, celery, and onion commonly found in chicken noodle soup are a great source of vitamins C and K, as well as other antioxidants and minerals. “Not only does this help build a healthy immune system to fight off viruses, it also helps your body recover from illness more quickly,” Allonen says.

Vegetables like carrots are also high in beta-carotene, and can help reduce symptoms due to their anti-inflammatory properties.

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Steam

While steam isn’t an ingredient you’ve mixed in, it’s important to serve your soup warm. Hot steam that comes from your cup of soup can be helpful in reducing nasal congestion.

“Steam can open up airways, making it easier to breathe. It also has a mild anti-inflammatory effect that can help relax your muscles and soothe the discomforts of cold symptoms,” Allonen says.

While soup won’t cure your cold completely, it’s a delicious way to load up on nutrients and increase hydration. Make an appointment with your primary care physician if you’re feeling under the weather this winter.

Black Children Tend to be Diagnosed with Autism Later than White Children

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The rate of diagnosis for autism spectrum disorders (ASD) is the same among all racial groups — one in 110, according to current estimates. However, a study by a Florida State University researcher has found that African-American children tend to be diagnosed later than white children, which results in a longer and more intensive intervention. The reasons for later diagnoses include a lack of access to quality, affordable, culturally competent health care, according to Martell Teasley, an associate professor in Florida State’s College of Social Work who has conducted a comprehensive review of researchliterature on autism and African-American children. In addition, the stigmaattached to mental health conditions within the black community contribute to misdiagnoses of autism, and underuse of available treatment services.

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“There are no subjective criteria for diagnosing autism. Only brain scans can truly provide appropriate diagnoses, because we are dealing with biological and chemical imbalances in the brain,” Teasley said. “Not every child is going to have access to this kind of medical evaluation, particularly those who are indigent and don’t have health care funding.”

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Teasley examined ASD diagnosis and treatment strategies, and their effect on African-American families, in “Autism and the African-American Community,” a paper published in a special issue of the journal Social Work in Public Health (Vol. 26, Issue 4, 2011) that dealt with health-care policy issues in the black community related to the human genome.

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Associate Professor in Florida State’s College of Social Work

Teasley co-wrote the paper with Ruby Gourdine, a professor of social work at Howard University in Washington, D.C., and Tiffany Baffour, an associate professor of social work at Winston-Salem State University in North Carolina. Because of the social stigma, Teasley says that some African-American families might be resistant to accept a diagnosis and treatment. “Less discussion about autism among African-Americans or between African-Americans and health care providers leads to misdiagnoses, a lack of treatment and a lack of services,” Teasley said.

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“This will lead to greater challenges for families — more stress and anxiety, and poorer developmental outcomes.” African-Americans also might resist a diagnosis and treatment because of a mistrust of mainstream health care providers over past discrimination. “African-Americans are well versed in going to a doctor who might have biases or discriminatory practices, so they may not readily accept what a doctor says,” Teasley said. In addition, a cultural divide between African-Americans and mainstream health care providers can hinder a timely and correct diagnosis.

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“There are not enough health care professionals who understand the cultural norms and attributes of the African-American community,” Teasley said. African-Americans live in all types of settings, but the majority live in urban areas, which have seen a decline in the number of mental-health care agencies since the 1980s. “This lack of accessibility causes a problem for some African-Americans,” Teasley said. Once a child is diagnosed with ASD, Teasley says both the child and the members of his or her family needs to receive appropriate training and counseling. “The children need behavioral counseling so they can develop the skills to live as independently as possible,” he said. “The families need to learn how to work with children who are autistic. “Intervention for any autistic child needs to start around age 3, so we can get the child to begin to learn how to eat right and develop normal, healthy routines, which will result in a better developmental outcome,” Teasley said. “Later intervention will result in a poorer developmental outcome that can have a lasting impact on the child’s and family’s quality of life.”

Martell Teasley, College of Social Work(850) 644-9595; mteasley@fsu.edu

“Could My Child Have Autism?”

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Ten Signs of Possible Autism-Related Delays in 6- to 12-Month-Old Children

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Though autism is often not diagnosed until the age of three, some children begin to show signs of developmental delay before they turn a year old. While not all infants and toddlers with delays will develop autism spectrum disorders (ASD), experts point to early detection of these signs as key to capitalizing on early diagnosis and intervention, which is believed to improve developmental outcomes.

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According to Dr. Rebecca Landa, director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore, Md., parents need to be empowered to identify the warning signs of ASD and other communication delays. “We want to encourage parents to become good observers of their children’s development so that they can see the earliest indicators of delays in a baby’s communication, social and motor skills,” says Dr. Landa, who also cautions that some children who develop ASD don’t show signs until after the second birthday or regress after appearing to develop typically.

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For the past decade, Dr. Landa has followed infant siblings of children with autism to identify red flags of the disorder in their earliest form. Her research has shown that diagnosis is possible in some children as young as 14 months and sparked the development of early intervention models that have been shown to improve outcomes for toddlers showing signs of ASD as young as one and two years old. Dr. Landa recommends that as parents play with their infant (6 – 12 months), they look for the following signs that have been linked to later diagnosis of ASD or other communication disorders: 1. Rarely smiles when approached by caregivers2. Rarely tries to imitate sounds and movements others make, such as smiling and laughing, during simple social exchanges3. Delayed or infrequent babbling4. Does not respond to his or her name with increasing consistency from 6 – 12 months 5. Does not gesture to communicate by 10 months6. Poor eye contact7. Seeks your attention infrequently8. Repeatedly stiffens arms, hands, legs or displays unusual body movements such as rotating the hands on the wrists, uncommon postures or other repetitive behaviors9. Does not reach up toward you when you reach to pick him or her up10. Delays in motor development, including delayed rolling over, pushing up and crawling

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“If parents suspect something is wrong with their child’s development, or that their child is losing skills, they should talk to their pediatrician or another developmental expert,” says Dr. Landa. “Don’t adopt a ‘wait and see’ perspective. We want to identify delays early in development so that intervention can begin when children’s brains are more malleable and still developing their circuitry.”

About the Kennedy Krieger Institute Internationally recognized for improving the lives of children and adolescents with disorders and injuries of the brain and spinal cord, the Kennedy Krieger Institute in Baltimore, MD serves more than 16,000 individuals each year through inpatient and outpatient clinics, home and community services and school-based programs. Kennedy Krieger provides a wide range of services for children with developmental concerns mild to severe, and is home to a team of investigators who are contributing to the understanding of how disorders develop while pioneering new interventions and earlier diagnosis. For more information on Kennedy Krieger Institute, visit: www.kennedykrieger.org.

Sugar changes the chemistry of your brain

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Anyone who has desperately searched their kitchen cabinets for a piece of forgotten chocolate knows that the desire for palatable food can be hard to control. But is it really addiction?

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The idea of food addiction is a very controversial topic among scientists. Researchers from Aarhus University have delved into this topic and examined what happens in the brains of pigs when they drink sugar water. The conclusion is clear: sugar influences brain reward circuitry in ways similar to those observed when addictive drugs are consumed. The results have just been published in the journal Scientific Reports.

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“There is no doubt that sugar has several physiological effects, and there are many reasons why it is not healthy. But I have been in doubt of the effects sugar has on our brain and behaviour, I had hoped to be able to kill a myth. ” says Michael Winterdahl, Associate Professor at the Department of Clinical Medicine at Aarhus University and one of the main authors of the work.

The publication is based on experiments done using seven pigs receiving two liters of sugar water daily over a 12-day period. To map the consequences of the sugar intake, the researchers imaged the brains of the pigs at the beginning of the experiment, after the first day, and after the 12th day of sugar.

“After just 12 days of sugar intake, we could see major changes in the brain’s dopamine and opioid systems. In fact, the opioid system, which is that part of the brain’s chemistry that is associated with well-being and pleasure, was already activated after the very first intake,” says Winterdahl.

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When we experience something meaningful, the brain rewards us with a sense of enjoyment, happiness and well-being. It can happen as a result of natural stimuli, such as sex or socializing, or from learning something new. Both “natural” and “artificial” stimuli, like drugs, activate the brain’s reward system, where neurotransmitters like dopamine and opioids are released, Winterdahl explains.

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We chase the rush

“If sugar can change the brain’s reward system after only twelve days, as we saw in the case of the pigs, you can imagine that natural stimuli such as learning or social interaction are pushed into the background and replaced by sugar and/or other ‘artificial’ stimuli. We’re all looking for the rush from dopamine, and if something gives us a better or bigger kick, then that’s what we choose” explains the researcher.

When examining whether a substance like sugar is addictive, one typically studies the effects on the rodent brain. ¨It would, of course, be ideal if the studies could be done in humans themselves, but humans are hard to control and dopamine levels can be modulated by a number of different factors. They are influenced by what we eat, whether we play games on our phones or if we enter a new romantic relationship in the middle of the trial, with potential for great variation in the data. The pig is a good alternative because its brain is more complex than a rodent and gyrated like human and large enough for imaging deep brain structures using human brain scanners. The current study in minipigs introduced a well-controlled set-up with the only variable being the absence or presence of sugar in the diet.

Background for the results:

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  • The study involved imaging the pig brain before and after sugar intake.
  • Partners involved in the study: Michael Winterdahl, Ove Noer, Dariusz Orlowski, Anna C. Schacht, Steen Jakobsen, Aage K. O. Alstrup, Albert Gjedde and Anne M. Landau.
  • The study was financed by a grant from AUFF to Anne Landau.
  • The scientific article has been published in Scientific Reports and is freely available online: doi: https://doi.org/10.1038/s41598-019-53430-9

The 69 genes that increase the risk for autism

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UCLA-led team compares DNA of children with the disorder to that of their siblings and parents

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A UCLA-led research team has identified dozens of genes, including 16 new genes, that increase the risk of autism spectrum disorder. The findings, published in the journal Cell, were based on a study of families with at least two children with autism.

Researchers from UCLA, Stanford University and three other institutions used a technique called whole genome sequencing to map the DNA of 2,300 people from nearly 500 families. They found 69 genes that increase the risk for autism spectrum disorder; 16 of those genes were not previously suspected to be associated with a risk for autism.

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Researchers also identified several hundred genes they suspect may increase the risk of autism based on their proximity to genes previously identified to carry an increased risk.  The study analyses further revealed several new biological pathways not previously identified in studies of autism.

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The findings shed light on how genetic variants or mutations — the differences that make each person’s genome unique — are passed from parents to children affected with autism, said the study’s co-lead author Elizabeth Ruzzo, a UCLA postdoctoral scholar. Former UCLA postdoctoral scholar Laura Pérez-Cano is the study’s other co-lead author.

“When we look at parents of autistic children and compare them to individuals without autism, we find that those parents carry significantly more, rare and highly damaging gene variants,” Ruzzo said. “Interestingly, these variants are frequently passed from the parents to all of the affected children but none of the unaffected children, which tells us that they are significantly increasing the risk of autism.”

Of the children in the study, 960 have autism and 217 children do not. That enabled researchers to analyze the genetic differences between children with and without autism across different families.

“Studying families with multiple children affected with autism increased our ability to detect inherited mutations in autism spectrum disorder,” said Dr. Daniel Geschwind, senior, corresponding author of the study and the Gordon and Virginia MacDonald Distinguished Professor of Human Genetics, Neurology and Psychiatry at the David Geffen School of Medicine of UCLA.

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“We show a substantial difference between the types of mutations that occur in different types of families, such as those that have more than one affected child versus those having only one child with ASD,” said Geschwind, who also was the study’s co-principal investigator and director of the UCLA Center for Autism Research and Treatment and director of the Institute of Precision Health at UCLA.

The research also found that the 16 genes newly determined to be associated with an increased risk for autism form a network with previously identified ASD risk genes. The way they interact with one another further heightens the risk, said the study’s co-senior author and co-principal investigator Dennis Wall, a Stanford University School of Medicine associate professor of pediatrics and of biomedical data science.

“They associate with each other more tightly than we’d expect by chance,” he said. “These genes are talking to each other, and those interactions appear to be an important link to autism spectrum disorder.”

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The nearly 600 genes researchers suspect as carrying an increased risk of autism were identified through “guilt by association,” or through their interactions with other genes that already have been shown to carry an increased autism risk, Ruzzo said.

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“And although not all of those genes will be found to increase the risk for autism, our analysis indicates that future studies will provide support for many of these genes,” she said.

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The families studied are part of the Autism Genetic Resource Exchange (AGRE), which was originally developed nearly two decades ago by researchers and the National Institutes of Health in collaboration with Cure Autism Now, which is now a program of Autism Speaks.

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Autism is a spectrum of neurological disorders characterized by difficulties with communication and social interaction. Geschwind has been working to identify the genetic causes and biological mechanisms of the disorder for more than a decade, and led the original development of the AGRE resource that was used in this study in the late 1990s. In 2018, he and colleagues at UCLA received their second, five-year grant from the NIH to expand autism research by studying genetic causes of autism in African American families.

Higher rates of post-natal depression among autistic mothers

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Autistic mothers are more likely to report post-natal depression compared to non-autistic mothers, according to a new study of mothers of autistic children carried out by researchers at the University of Cambridge

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A better understanding of the experiences of autistic mothers during pregnancy and the post-natal period is critical to improving wellbeing. The results are published in Molecular Autism.

The team recruited an advisory panel of autistic mothers with whom they co-developed an anonymous, online survey. After matching, this was completed by 355 autistic and 132 non-autistic mothers, each of whom had at least one autistic child.

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Sixty percent of autistic mothers in the study reported they had experienced post-natal depression. By comparison, only 12% of women in the general population experience post-natal depression. In addition, autistic mothers had more difficulties in multi-tasking, coping with domestic responsibilities, and creating social opportunities for their child.

The study also found that when autistic mothers disclosed their autism diagnosis to a professional, they were not believed the majority of the time. Autistic women felt misunderstood by professionals more frequently during pre- and post-natal appointments and found motherhood an isolating experience. Despite these challenges, autistic mothers reported they were able to act in the best interest of their child, putting their child’s needs first and seeking opportunities to boost their child’s self-confidence.

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Dr Alexa Pohl, who led the study, said: “Autistic mothers face unique challenges during the perinatal period and parenthood. Despite these challenges, an overwhelming majority of autistic mothers reported that parenting overall was a rewarding experience. This research highlights the need for increased awareness of the experiences of motherhood for autistic women and the need for more tailored support.”

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Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, and part of the team, said: “This worryingly high number of autistic mothers who experience post-natal depression means we are failing them and their infants at a critical point in their lives. We now need more research into why the rates are so much higher, whether they are seeking help and not getting it, or if they are not seeking help and for what reasons. A new research priority is to develop autism-relevant screening tools and interventions for post-natal depression in these mothers.”

Monique Blakemore, an autistic advocate and member of the team, said: “This vital study was initiated by the autistic community, who collaborated as equal partners with researchers in the design, dissemination and interpretation of the survey. This is an excellent example of what can be achieved through such partnership.”

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The study was supported by the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), East of England, at Cambridgeshire and Peterborough NHS Foundation Trust, the Autism Research Trust, the MRC, the NIHR Cambridge Biomedical Research Centre, and Autistica.

Reference

A comparative study of autistic and nonautistic women’s experience of motherhood by Alexa Pohl, Sarah Crockford, Monique Blakemore, Carrie Allison and Simon Baron-Cohen. Molecular Autism. DOI: 10.1186/s13229-019-0304-2

When should a young girl visit a gynecologist?

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According to the American College of Obstetricians and Gynecologist, girls should have their first gynecologic visit between the ages of 13 and 15 years old.

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Parents of young teenage girls are probably thinking about how to help them navigate social media, classwork, and their social lives. However, as young teenagers begin to go through puberty, it is also important to help them understand how to manage their changing bodies. Scheduling an appointment with a pediatric and adolescent gynecologist is one way to do this.

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According to the American College of Obstetricians and Gynecologist, girls should have their first gynecologic visit between the ages of 13 and 15 years old. Pediatric and adolescent gynecology is a subspecialty of gynecology that provides comprehensive care for girls from birth to early adulthood. Pediatric and adolescent gynecologists take special care of the emotional needs of their patients and families while providing the unique care that’s necessary to foster the child’s transition from pediatrics to adult gynecology.

We spoke with pediatric gynecologist Amber Truehart, MD, about other reasons a girl should visit a gynecologist before she becomes an adult.

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Education and Examinations

Patient education is one highlight of building a relationship with a pediatric and adolescent gynecologist. During the first visit, the doctor will help reinforce an understanding of healthy body weight and good habits for healthy bones. This is also an opportunity for young patients to learn about basic female hygiene, normal versus abnormal vaginal discharge, and puberty. Additionally, depending on the patient’s individual needs, their physical and emotional development, and medical history, the doctor may perform a basic physical exam, possibly including a breast exam.

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Menstrual Cycle

Most girls get their first period when they are between 10 and 15 years old. So, it’s likely that a young girl is beginning to think about her period around this time. A visit with a pediatric and adolescent gynecologist will help her learn about the menstrual cycle and what is considered normal or abnormal. She can also learn how to manage her cycle, pain relief, and how to deal with premenstrual syndrome (PMS).

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Vaccinations

Young girls are able to get the HPV vaccine at their gynecologist’s office. The HPV vaccine helps protect children from developing the human papillomavirus, which can lead to six types of cancers later in life. The Centers for Disease Control and Prevention recommends two doses of the HPV vaccine, the first at age 11 and then six months later. If the child waits until age 15, they’ll need three doses of the vaccine.

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Sex Talks

Let’s face it — it may be difficult for a young girl to talk to a parent about sex. Yet, it’s important that she have an avenue for these conversations. Getting her in front of an expert she trusts will help her get accurate information and learn about sexually transmitted infections, HIV, and pregnancy prevention. She can also talk with her gynecologist about safe and healthy intimate relationships, LGBTQ topics and having sex for the first time.

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Special Assessments

For girls and young women who need complex gynecologic care, forming a doctor-patient relationship connects them with an expert who is poised to provide a full range of specialized services. Pediatric and adolescent gynecologists are trained to care for the intricate needs of children and teens who have physical or mental disabilities, congenital gynecologic abnormalities (present since birth), and underlying chronic health problems.

Exercise and Anxiety Reduction in Children with Autism

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An Autism Intervention Research Network on Physical Health grant supports the research

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The Center for Autism & Neurodevelopmental Disorders will begin a research study using physical exercise to reduce anxiety in children with Autism Spectrum Disorder (ASD) among underserved populations.

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This initiative is made possible through a grant from the Autism Intervention Research Network on Physical Health (AIR-P). Jean Gehricke, Ph.D., associate professor of pediatrics at UC Irvine and a licensed clinical psychologist with The Center for Autism & Neurodevelopmental Disorders, is the principal investigator of the study. The four-year study is receiving $103,125 for its initial year, with the potential overall total of $790,625. Gehricke expects to enroll participants by early fall.

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“We are excited to be chosen as the only site nationwide to receive this AIR-P grant to study the impact of exercise on anxiety, which is very common and can lead to poor outcomes in children with autism,” Gehricke said. “The grant will allow us to collect valuable data that could significantly improve long-term physical and mental health, particularly in underserved communities.”

A growing international body of research is confirming the wide-ranging benefits of exercise in reducing stress and improving the long-term health of children and adults alike. This study will determine the potential benefits of exercise in underserved children with ASD.

“We often tell our families to encourage their children with autism to get out and exercise,” said Kelly McKinnon, M.A., BCBA, co-investigator on the project. “It’s exciting to be able to study its impact and share the results with our families.”

The physical exercise research program is being designed to incorporate comprehensive new guidelines for physical exercise in children developed by the Centers for Disease Control and Prevention. Researchers will measure impact based on several key factors, including compliance, anxiety and salivary cortisol levels measured before and after completion of the exercise and control group interventions. Cortisol is a frequently used biomarker for stress, Gehricke explained.

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Collecting this data will aid in the development of an evidence-based physical exercise intervention toolkit for the treatment of anxiety as well as other behaviors and improvement of physical health in children with ASD from underserved populations.

“Research is one of the core pillars of our mission,” said Catherine Brock, M.A., executive director of The Center for Autism & Neurodevelopmental Disorders. “With this grant and Jean Gehricke’s pioneering research efforts, we will be better able to help parents and families overcome obstacles they face and assist children in reaching their optimal potential.”

For more information, please visit http://www.thecenter4autism.org.

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About The Center for Autism & Neurodevelopmental DisordersFounded in 2001 (originally as For OC Kids), The Center is home to a team of experts in the field of autism and neurodevelopmental disorders. Since its opening, The Center has been a leader in clinical services, research, education, and outreach, serving clients from birth through 22 years old.

In late 2012, a catalytic investment by the Thompson Family Foundation and the Children and Families Commission of Orange County provided $14.8 million to expand The Center for Autism & Neurodevelopmental Disorders.

The Center was established to provide help and hope to children, adolescents, young adults and their families challenged by autism spectrum and other neurodevelopmental disorders through excellent clinical care, innovative research, quality education, and community engagement. For more information, please visit http://www.thecenter4autism.org.