Children with autistic spectrum disorders. II: parents are unable to distinguish secretin from placebo under double-blind conditions.

BACKGROUND: Standardised measures of behaviour have failed to detect short term improvement in children with autism following treatment with secretin. However, it is possible that standardised measures are insensitive to dimensions of child behaviour that are nonetheless detectable by parents. AIM: To determine the ability of parents of children with autism to guess, under double blind conditions, whether their child had received secretin or placebo. METHODS: 2x2 crossover randomised blinded study, comparing the effect of synthetic human secretin 2 U/kg to placebo (saline). Sixty two children with autism (aged 43-103 months) were randomly allocated to two groups: group 1 received placebo, followed six weeks later by secretin, and group 2 received secretin followed by placebo. At the conclusion of the study, parents were asked to guess their child's group assignment. RESULTS: Twenty seven families guessed their child's group assignment correctly and 27 guessed incorrectly. In 48 instances, parents based their guess on perceived improvement; in six cases, parents based their guess on perceived deterioration. Six families saw no difference after either infusion, and offered no guess. One family dropped out after the first infusion, and one family was lost to follow up after the second infusion. CONCLUSION: In a controlled setting, parents of young children with autism are unable to distinguish the short term behavioural effects of secretin from placebo.     

Aggregation of childhood leukemia in geographic areas of Greece)

A total of 872 children aged up to 14 years, who were diagnosed withleukemia in Greece during the decade 1980-89, were allocated by place ofresidence to the 601 administrative districts of the country. Evaluation ofspatial clustering was done using the Potthoff-Whittinghill method, whichvalidly assesses heterogeneity of leukemia risk among districts with variableexpected numbers of cases. There was highly significant evidence for spatialclustering occurring particularly among children living in urban and, to alesser extent, semi-urban areas. The evidence was stronger for childrenyounger than 10 years old, applied also to children in different five-yearage groups, and persisted when cases of acute lymphoblastic leukemia wereanalyzed separately. These findings provide support to the hypothesis thatlocalized environmental exposures could contribute to the etiology ofchildhood leukemia, but they cannot distinguish between exposures of physicalor chemical nature, nor can they exclude socially conditioned patterns ofexposure to infectious agents.     

Mono- and Diterpenes from Cell Cultures of Thuja occidentalis

Cell cultures of THUJA OCCIDENTIALIS L. were found to biosynthesize various mono- and diterpenes when grown on B5-medium. The identification of the constituents was achieved mainly by capillary GLC-MS using fused silica columns and E.I.-mass spectrometry. Monoterpenes of the menthane type were only isolated from the culture medium whereas diterpenes were found in the cell extracts. Thujaplicin derivatives, monoterpenes of an irregular type, were detected in the medium as well as in the cells. Major differences were found between the terpene composition of the cell culture extracts and those from THUJA leaves. The cell cultures accumulated some compounds which are presently unknown as constituents of THUJA plants. On the other hand, the cultures were evidently unable to synthesize the thujone type of monoterpenes.     

Further new staurosporine derivatives from the ascidian Eudistoma toealensis and its predatory flatworm Pseudoceros sp

Three new indolocarbazole alkaloids, 3-hydroxy-4'-N-methylstaurosporine (3), 3-hydroxy-4'-N-demethylstaurosporine (4), and 3'-demethoxy-3'-hydroxy-4'-N-demethylstaurosporine (5), were isolated from the marine ascidian Eudistoma toealensis and its predatory flatworm Pseudoceros sp. in addition to two known staurosporines. The structures were determined by 1D and 2D homonuclear and 1H-detected heteronuclear NMR spectroscopy and from comparisons with published data. CD measurements for these five staurosporine derivatives, as well as the previously described seven staurosporines, are reported, confirming that all derivatives possess the 2'S,3'R,4'R,6'R configuration.     

Treatment of Chronic Hidradenitis Suppurativa; Surgical Modification

Chronic hidradenitis suppurativa causes painful discomfort as well as social embarrassment. An intensive search for adequate therapy has not yielded a widely accepted method for treating the different stages of this disease. A surgical modification which drained the chronic foci of infection and eliminated the cavity lining was successful in 35 patients treated by the authors. They recommend that even a single chronic lesion should be treated by this method.     

Gluten-sensitive recurrent aphthous stomatitis

Twenty selected patients with recurrent aphthous stomatitis in whom celiac disease had been specifically excluded were placed on a gluten-free diet. Five patients (25%) showed a favorable response to gluten withdrawal and a positive gluten challenge. Jejunal morphology was normal in all patients indicating gluten sensitivity without enteropathy. Gluten withdrawal provides a further method of treating some patients with recurrent aphthous stomatitis.     

Precipitins to an aflatoxin-producing strain of aspergillus flavus in patients with malignancy

Summary Serum samples from 121 patients in whom malignant disease had been diagnosed, were assayed for precipitins to fungal isolates from leukemia-associated environments. Control sera were from age-, sex-, and race-matched patients with no history of malignant disease. Sera from 36 (30%) malignancy patients and seven (6%) controls yielded a precipitin band to an aflatoxin-producing Aspergillus flavus isolate from a leukemia-associated house ², p<0.05%). No significant numbers of precipitins were obtained to either of the other fungal isolates from that and another such house.Although A. fumigatus has frequently been incriminated as a source of infection in patients with malignancy, only 9% of malignancy patients had a precipitin response to it, as did 1.6% of controls. Also, the presence of the precipitins to A. flavus was not connected with past radiation or imunosuppressive therapy. However, among patients with precipitins to A. fumigatus there was a higher death rate in the year following the study. Precipitins to A. flavus may be related to heavy environmental exposure possibly leading to aflatoxin exposure which may contribute to development of malignancy through immunosuppressive effects.