The success of a five-minute check that can be administered to one-year-olds to detect subtle signs of autism is leading to hopes it can someday become part of a routine checkup.
Published in the Journal of Pediatrics, researchers set up a trial network of 137 pediatricians across San Diego County and invited them to a one-hour seminar on how to administer a checklist as part of their standard one-year infant checkup.
The list is made up of a brief 24-item questionnaire designed to spot signs of autism spectrum disorder, language delay and developmental delay. Parents answer questions about how their child uses eye contact, words, sounds, objects, gestures and other ways of communicating. Any children identified after the screening were referred to the research team and tested every six months until their third birthday.
In total, 10,479 babies were screened using the checklist. Of those, 184 were referred for further evaluation, of which 32 were provisionally or officially diagnosed with autism spectrum disorder, 56 were diagnosed with a language delay, nine had a developmental delay and 36 had some other form of delay. Those numbers meant the checklist screen had a predictive value of 75 per cent. All of the pediatricians who took part in the study now use the checklist as part of their annual checkups for infants.
The research team now wants the checklist validated and refined so it can be used more widely.
Heart attacks that occur in the morning, between 6 a.m. and midday, cause more damage to the heart than those that occur at other times of the day, according to a study in the journal Heart.
Doctors and scientists know that the body’s 24-hour clock impacts different cardiovascular physiological processes, including heart attacks, and that these processes are at their peak when people wake up. However there have been no studies that examine how much damage a morning heart attack causes.
A research team in Spain decided to find out what impact the time of day of a heart attack had on the size of dead tissue on the heart. They focused on patients who suffered STEMI heart attacks or ST segment elevation myocardial infarction, where the blood supply is blocked for a long time. The team gathered information on 811 patients who had a STEMI heart attack between 2003 and 2009 and examined the enzyme release in patients to determine how much dead tissue the heart attack had caused.
The team found the amount of dead tissue (or infarct size) was 21 per cent greater in patients who had a STEMI heart attack between 6 a.m. and midday than those who had a heart attack between 6 p.m. and midnight. They also found a plurality of patients (269) had their heart attacks during that time, compared to 240 between midday and 6 p.m., 161 between 6 p.m. and midnight and 141 between midnight and 6 a.m.
Women who have a hysterectomy in which the ovaries are also removed have a reduced risk of developing ovarian cancer. Furthermore, they have no higher risk of developing other types of cancer, cardiovascular disease or hip fractures.
Published in the Archives of Internal Medicine, a team of researchers collected data on 25,000 women who were 50 to 70 years of age and had undergone a hysterectomy. Of that number, 56 per cent had their ovaries removed at the time of hysterectomy and 79 per cent had received hormone replacement therapy. The women were followed for an average of seven to eight years to find out how many developed heart disease, hip fractures or ovarian cancer.
In total, the team found that ovarian cancer developed in one in every 300 women who had a simple hysterectomy compared to one in 5,000 who also had their ovaries removed. Both groups had the same risk of developing a hip fracture or heart disease, at eight in 1,000 annually.
Postmenopausal women who have their ovaries removed do not have significantly different hormone levels compared to those who keep their ovaries and the difference is not enough to impact long-term health, according to the study authors.
Researchers did find the women in the study had a moderately higher risk of hypertension and angina.
The findings go against the Nurses’ Health Study, which implied an association between having the ovaries removed at time of hysterectomy and a higher risk of cancer deaths, heart disease and mortality in general. That study was larger, had a longer follow-up period and only covered women aged 51 to 63 years.
The controversy over removal of the ovaries has come to light since the increased risks of undergoing hormone replacement therapy were discovered, which included higher risks of stroke, heart disease and cancer. When the therapy subsequently became less popular, the subject of removing ovaries from women with no family history of ovarian cancer became controversial.
