The TEACCH program for children and adults with autism: A meta-analysis of intervention studies

The intervention program for autism known as Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) is considered an emerging practice for autism. In the present study we used state-of-the-art meta-analytical procedures to examine the pooled clinical effects of TEACCH in a variety of outcomes. A total of 13 studies were selected for meta-analysis totaling 172 individuals with autism exposed to TEACCH. Standardized measures of perceptual, motor, adaptive, verbal and cognitive skills were identified as treatment outcomes. We used inverse-variance weighted random effects meta-analysis supplemented with quality assessment, sensitivity analysis, meta-regression, and heterogeneity and publication bias tests. The results suggested that TEACCH effects on perceptual, motor, verbal and cognitive skills were of small magnitude in the meta-analyzed studies. Effects over adaptive behavioral repertoires including communication, activities of daily living, and motor functioning were within the negligible to small range. There were moderate to large gains in social behavior and maladaptive behavior. The effects of the TEACCH program were not moderated by aspects of the intervention such as duration (total weeks), intensity (hours per week), and setting (home-based vs. center-based). While the present meta-analysis provided limited support for the TEACCH program as a comprehensive intervention, our results should be considered exploratory owing to the limited pool of studies available.     

Inhibition of rat carotid body glomus cells TASK-like channels by acute hypoxia is enhanced by chronic intermittent hypoxia

Chronic intermittent hypoxia (CIH), the main feature of obstructive sleep apnea, enhances carotid body (CB) chemosensory responses to acute hypoxia. In spite of that, the primary molecular target of CIH in the CB remains unknown. A key step of the hypoxic response in the CB is the chemoreceptor cell depolarization elicited by the inhibition of K⁺ channels. Thus, we tested the hypothesis that CIH potentiates the hypoxic-induced depolarization of rat CB chemoreceptor cells by enhancing the inhibition of a background K⁺ TASK-like channel. Membrane potential, single channel and macroscopic currents were recorded in the presence of TEA and 4-aminopyridine in CB chemoreceptor cells isolated from adult rats exposed to CIH. The CIH treatment did not modify the resting membrane properties but the hypoxic-evoked depolarization increased by 2-fold. In addition, the hypoxic inhibition of the TASK-like channel current was larger and faster in glomus cells from CIH-treated animals. This novel effect of CIH may contribute to explain the enhancing effect of CIH on CB oxygen chemoreception.     

Choroidal thickening in a case of carotid cavernous fistula

A 47-year-old woman was diagnosed with dural carotid cavernous fistula (CCF) in her right eye (RE). Scans of the choroid using Spectralis optic coherence tomography (OCT) demonstrated significant asymmetry in subfoveal choroidal thickness (RE 451 μm, left eye (LE) 367 μm). This asymmetry disappeared after the fistula was embolizated through the ophthalmic artery (RE 341 μm; LE 340 μm). This case suggests that OCT should be considered as an ancillary test in the diagnosis of CCF.     

Management of post-goniopuncture iris herniation: a two-step procedure

A 38-year-old male presented to the emergency room suffering acute pain in his left eye. Two months before he had been submitted to uneventful non-penetrating deep sclerectomy and one month before to YAG-laser goniopuncture. Examination showed iris herniation into the trabeculo-descemet’s window. Surgical reduction was carried out through a peripheral corneal incision, and a large air bubble was injected into the anterior chamber. Four days later a wide laser peripheral iridotomy was performed. This technique can transform a non-penetrating technique into a full-trabeculectomy, without reopening the superficial flap.     

The Role of Alpha Tocopheryl Succinate (α-TOS) as a Potential Anticancer Agent

In recent years, efforts to improve cancer therapy have focused on developing new anticancer agents, such as mitocans. These agents include vitamin E analogues and suppress cancer by inducing apoptosis by targeting mitochondria. Alpha tocopheryl succinate (α-TOS) is the most effective form of vitamin E analogues causing inhibition of proliferation and apoptosis of cancer cells. Both in vitro and in vivo studies have demonstrated that α-TOS selectively kills tumor cells with little or no effect on normal cells. Treatment with α-TOS shows great promise for future clinical applications, as it causes cell death, at least in part, by selectively inducing apoptosis by mitochondrial destabilization. This review presents an overview of perspectives on α-TOS and the potential uses of α-TOS in cancer treatment and other clinical applications.