Adults With Autism Should be Considered a Priority in COVID-19 Immunization Programs

Journal of Autism and Developmental Disorders -     

Radiofrequency in female external genital cosmetics and sexual function: a randomized clinical trial

Introduction and hypothesis

Female sexual behavior goes through cultural changes constantly, and recently, some women have shown the desire the ideal genitalia. In this study, we aimed to evaluate clinical responses to nonablative radiofrequency (RF) in terms of its cosmetic outcome in the female external genitalia and its effect on sexual function.

Methods

A single-masking randomized controlled trial was conducted in 43 women (29 sexually active) who were unsatisfied with the appearance of their external genitalia. The women were divided into an RF group (n?=?21, 14 sexually active) and a control group (n?=?22, 15 sexually active). Eight sessions of RF were performed once a week. Photographs (taken before the first session and 8 days after the last session) were evaluated by the women and three blinded health professionals by using two 3-point Likert scales (unsatisfied, unchanged, and satisfied; and worst, unchanged, and improved). Sexual function was evaluated using the Female Sexual Function Index (FSFI) and analyzed using the Student t test. Women’s satisfaction and health professional evaluation were analyzed using the chi-square test and inter- and intragroup binomial comparisons.

Results

Satisfaction response rates were 76 and 27 % for the RF and control groups, respectively (p?=?0.001). All professionals found a clinical improvement association in the treated group with RF in comparison with the control group (p?<?0.01). The overall FSFI sexual function score increased by 3.51 points in the RF group vs 0.1 points in the control group (p?=?0.003).

Conclusions

RF is an alternative for attaining a cosmetic outcome for the female external genitalia, with positives changes in patients’ satisfaction and FSFI scores.

     

The Ilha de Maré study: a survey of child mental health problems in a predominantly African-Brazilian rural community

BACKGROUND: There have been very few Brazilian epidemiological surveys of child mental health problems. The only recent survey to have used internationally recognised measures and diagnostic criteria was carried out in Southeast Brazil in a relatively prosperous setting where the population was predominantly urban and white. METHODS: The setting was an island community in Northeast Brazil that is rural, relatively poor and has a strong African heritage. In an initial phase, a simple random sample of 519 children aged 5-14 was assessed by screening questionnaires completed by parents, teachers and older children. In a second phase, a sub-sample of 100 children was selected for more detailed diagnostic assessments. RESULTS: Conduct and hyperactivity problems were commoner in boys; emotional symptoms were commoner in girls; and hyperactivity declined with age. By contrast with previously collected data from Southeast Brazil, there were more reported symptoms, but less resultant impact. Using a variety of indices, the rate of disorder on Ilha de Maré was around half that previously found in Southeast Brazil. CONCLUSION: The measures and diagnostic criteria that were employed appeared valid for use in Northeast Brazil, though there was evidence for consistent over-reporting of symptoms on the screening questionnaire. Rates of child mental health problems appear to differ substantially between sites, confirming the need for a multi-site Brazilian study of the prevalence of child psychiatric disorders.     

Pharmacokinetics of HD-MTX in infants,children, and adolescents with non-B acute lymphoblastic leukemia

A retrospective pharmacokinetic analysis was done of methotrexate serum levels after high-dose treatment (HD-MTX, four cycles at two-week intervals of 5 g/sq.¹m. over 24 h i.v.) in children with non-B acute lymphoblastic leukemia (ALL) with the specific aim of seeking differences in patients of different ages, including infants under one year. A total of 122 children (seven infants aged 3 months-1 year, 26 children aged 1–3 years, 68 children aged 3–10 years and 21 adolescents aged 10–15 years) with normal liver and renal function, receiving consolidation therapy at the Pediatric Clinic of Monza between May 1988 and April 1992, were enrolled in this study. MTX was given as an intravenous infusion in 24 h and serum concentrations were measured up to at least 72 h after the start of infusion by an enzyme immunoassay (TDX Abbot, Dallas, TX) in order to modulate folinic acid rescue. Pharmacokinetic analysis of MTX levels according to a two-compartment open model indicated that, compared to all children up to 10 years old, in adolescents older than 10 years the drug reached higher concentrations in serum and was cleared at a lower rate. Steady-state levels and AUC were from 60% higher to more than double and the total clearance of the compound, expressed either per square meter surface area or per kg body weight, in each cycle was significantly lower in adolescents >10 years of age, sometimes being only one-third of the clearance in infants (0.2 vs. 0.6 1/h/kg and 6.6 vs. 10.7 1/h/sq.m). The relationship between each age and systemic clearance was highly significant as measured by regression analysis. Methotrexate systemic clearance progressively decreased as a function of age. Subsequent treatments did not induce changes in MTX pharmacokinetics. These data suggest that the better tolerance of HD-MTX in children may have a pharmacokinetic basis. The faster elimination of MTX in infants, who usually show the worst prognosis, suggests that full doses could be safely used in order to maximize the antileukemic effect without a high risk of toxicity. © 1995 Wiley-Liss, Inc.