Lower maternal serum 25(OH) D in first trimester associated with higher autism risk in Chinese offspring

ObjectiveThe aim of this study was to examine the association between maternal serum vitamin D status in first trimester and risk of ASD at age 3–7 years in the offspring.MethodsUsing a case-control design, 68 children diagnosed with ASD and 68 sex and age matched typically-developing children were included. Archived maternal blood samples from the first trimester of pregnancy (11–13 weeks gestational age) were identified for those participants. Maternal serum levels of 25 hydroxyvitamin D3 [25(OH) D], unmetabolized folic acid (FA), vitamin B12, homocysteine (HCY) and High Sensitivity C Reactive protein (CRP) were measured from those samples. We examined the associations between those factors in pregnancy and diagnosis of ASD with logistic regression using SPSS.ResultsMothers in autistic group had significantly lower maternal serum levels of 25(OH) D than in typically-developing group [19.2(IQR: 15.8–22.9)ng/ml vs. 24.3(19.3–27.3)ng/ml, P < 0.001], with 55.9% and 29.4% being vitamin D deficient, respectively (P < 0.001). Levels of 25(OH) D increased with decreasing severity of ASD as defined by the CARS score (r = − 0.302, P < 0.001). Maternal first trimester serum levels of 25(OH) D in the lower 3 quartiles (quartile 1, 2, 3) (compared to the highest quartile) was associated with increased odds of ASD diagnosis in offspring [OR (95% CI) Q1: 1.36(0.84–2.58, P = 0.25); Q2: 2.68(1.44–4.29, P = 0.006); Q3:3.99(2.58–7.12, P < 0.001)].ConclusionsLower first trimester maternal serum levels of 25(OH) D were associated with increased risk of developing autism in offspring. If these findings are confirmed, this may present an opportunity for prenatal intervention to reduce the risk for ASD.     

Keeping a healthy distance: Self-differentiation and perceived health among ex-prisoners-of-war's wives

ObjectiveWar captivity may affect spouses of former-prisoners-of-war (ex-POWs) in many ways, including posttraumatic stress symptoms (PTSS) and somatic difficulties manifested in negative perceived health. This is generally known as secondary traumatization. Theory suggests that development of secondary traumatization occurs through the relationship with the primary trauma survivor Figley (1986) , thus implying that the ability to keep balanced emotional distance in the relationship may play a pivotal role. Notwithstanding, the contribution of self-differentiation to secondary somatic disturbances remains largely uninvestigated. The current study fills this gap.MethodsEx-POWs' wives (n = 143) and control former-combatants' wives (n = 102), were assessed prospectively 30 (T1) and 38 (T2) years after the 1973 Yom Kippur War. Self-differentiation and PTSS were assessed at both time-points, while perceived health measures were assessed at T2.ResultsWives of ex-POWs endorsed higher PTSS, lower self-differentiation and negative perceived health, compared to control wives. Indirect exposure to war captivity was related to low self-differentiation and elevated PTSS, which predicted negative perceived health. Furthermore, self-differentiation characterized by fusion-with-others fully mediated the relation between indirect exposure to war captivity and perceived health, beyond the effects of PTSS as a mechanism.ConclusionResults suggest that tendencies towards fusion-with-others within the marital relationship, act as a risk factor not only for psychological distress but also for somatic distress among secondary trauma survivors. Hence, clinical interventions may seek to improve indirect trauma survivor's self-differentiation capacities, thus potentially facilitating the prevention of secondary somatic distress.     

成人肱骨髁间骨折的治疗

目的:研究成人肱骨髁间骨折治疗及预后情况,以便能够及时有效对其进行合理的治疗。方法:肱骨髁间骨折患者28例,男22例,女6例;年龄21~57岁,平均41.4岁。按Muller分型,C1型8例,C2型12例,C3型8例。所有病例采用侧卧位,肘关节后正中略向内侧弧形切口。应用塑形的Y形钢板与螺钉在肱骨髁部后方对骨折进行固定,术后早期功能锻炼。结果:28例均获得随访,随访时间18~62个月,平均35个月。按Aitken与Rorabeck的评分标准:优15例,良10例,一般2例,差1例,优良率89.3%(25/28)。术后早期尺神经麻痹3例,肘关节异位骨化2例,所有患者仅有1例进行了尺神经前移手术。结论:将钢板置于肱骨背侧可以保证成人肱骨髁间骨折牢固的固定而无须对尺神经与肌肉进行广泛的剥离与牵拉,从而可降低骨折并发症发生率。