Diagnostic accuracy of the ADOS and ADOS-2 in clinical practice.

The Autism Diagnostic Observation Schedule is a semi-structured, standardized assessment tool for individuals with suspected autism spectrum disorders (ASD) and is deemed to be part of the gold standard for diagnostic evaluation. Good diagnostic accuracy and interpersonal objectivity have been demonstrated for the ADOS in research setting. The question arises whether this is also true for daily clinical practice and whether diagnostic accuracy depends on specialized experience in the diagnostic evaluation. The present study explores the diagnostic accuracy of the original and the revised version of the ADOS for Modules 1 through 4. Thus, seven cases of ADOS executions were recorded and coded by a group of experts of specialized outpatient clinics for ASD. In an extensive consensus process, including video analysis of every minute of the ADOS executions, a "gold standard" coding for every case was defined. The videos of the ADOS administration were presented to a large group of clinicians (from daily clinical routine care) and their codings (n = 189) were obtained and analysed. Variance of coding and congruence with the expert coding were determined. High variance was found in the codings. The accuracy of the coding depends on the experience of the coder with the ADOS as well as on characteristics of the cases and the quality of the administration of the ADOS. Specialization in the diagnostic of ASD has to be claimed. Specialized outpatient clinics for ASD are required which guarantee a qualified diagnostic/differential diagnostic and case management with the aim of demand-oriented supply of individual cases.

Secular changes of anthropometric measures for the past 30 years in South-West Germany.

We investigated long-term changes in weight and skinfold thicknesses in German schoolchildren. In 2006, anthropometric measures were collected after a standardized protocol among 1079 children within the Ulm Research on Metabolism, Exercise and Lifestyle in children (URMEL-ICE) study. Data were compared with historical data (1975-1976). In URMEL-ICE, prevalence of overweight (IOTF criteria) was 16.5% (boys) and 17.3% (girls) and of obesity 3.5 and 3.6%, respectively. Compared with historical data the number of children above the 90th percentile(1975/76) increased statistically significantly for weight (approximately 150% both sexes), for subscapular (boys 288%, girls 206%) and triceps skinfold thickness (boys 460%, girls 413%). Statistically significant increases above the 50th percentile(1975/76) were found: weight 36 and 26%, subscapular 43 and 60% and triceps skinfold thickness 63 and 69% for boys and girls, respectively. Body fat among 6- to 9-year-old children increased dramatically within 30 years. Moreover, our data suggest substantial changes in body composition among normal-weight children towards an increased body fat mass.

[Synergism of ciprofloxacin with beta-lactam antibiotics, gentamicin, minocycline and pipemidic acid]. / Untersuchungen zum Synergismus von Ciprofloxacin mit beta-Laktam-Antibiotika, Gentamicin, Minozyklin und Pipemidsäure.

Studies on the Synergism of Ciprofloxacin with beta-Lactam Antibiotics, Gentamicin, Minocycline and Pipemidic Acid. Using Escherichia coli, Klebsiella pneumoniae/Klebsiella oxytoca, Pseudomonas aeruginosa and Staphylococcus aureus strains, we examined a possible influence of pipemidic acid, minocycline, gentamicin, cefazolin, mezlocillin and ampicillin on the antibiotic activity of ciprofloxacin. We found in all bacterial species synergistic influence by pipemidic acid. When ciprofloxacin was combined with gentamicin, synergism was observed in E. coli and in K. pneumoniae/oxytoca, additive effects in P. aeruginosa and S. aureus. In combination with minocycline we demonstrated synergism in S. aureus only. In all other bacterial species and antibiotic combinations we found neither synergism nor antagonism.