Plasma oxysterol profiling in children reveals 24-hydroxycholesterol as a potential marker for Autism Spectrum Disorders.

Cholesterol and its oxygenated metabolites, such as oxysterols, are intensively investigated as potential players in the pathophysiology of brain disorder. Altered oxysterol levels have been described in patients with numerous neuropsychiatric disorders, including Alzheimer's disease, Amyotrophic Lateral Sclerosis, Parkinson's disease, X-linked adrenoleukodystrophy, and Smith-Lemli-Opitz Syndrome. Recent studies have shown that Autism Spectrum Disorders are associated with disruption of cholesterol metabolism. The present study aimed at investigating the profile of oxysterols in plasma and their association with clinical parameters in patients with Autism Spectrum Disorders. Thirty-six children with Autism Spectrum Disorders and thirty-eight healthy children, from Sfax (a southern area of Tunisia) matched for age and sex, were included in the study. The severity of Autism Spectrum Disorders was evaluated using the childhood autism rating scale. Standard lipid profile (total cholesterol, triglycerides, and high-density lipoprotein-cholesterol), serum glucose, high-sensitive C-reactive protein and orosomucoid levels were measured utilizing standard techniques. Oxysterol levels were measured by isotope-dilution gas chromatography/mass spectrometry. Standard lipid profile, serum glucose, high-sensitive C-reactive protein and orosomucoid levels were similar between the two studied populations. Compared to the control group, children with Autism Spectrum Disorders showed a significant higher plasma level of 24-hydroxycholesterol, while borderline significance was observed for 7α-hydroxycholesterol, and 25-hydroxycholersterol. In patients, 24-hydroxycholesterol was inversely correlated with age. Multivariate analysis showed that high plasma levels of 24-hydroxycholesterol are independent risk factors for Autism Spectrum Disorders. On the other hand, an analysis of the receiver's operating characteristics proved that the measured parameters recorded satisfactory levels of specificity and sensitivity. The present study provides evidence that Autism Spectrum Disorders are associated with altered levels in circulating oxysterols. The finding that 24-hydroxycholesterol is an independent risk factor for the disease and suggests the use of this oxysterol as a diagnostic tool in Autism Spectrum Disorders.

[Problematic Internet use among teenagers in Sfax, Tunisia]. / Prévalence de l'usage problématique d'Internet chez les adolescents, Sfax, Tunisie.

UNLABELLED: Use of the Internet in Tunisian society and especially among teenagers has increased in recent years. While the use of Internet is primarily intended for research and communication, the Internet has also become an important part of teenager's life. Most people use the Internet in healthy and productive ways. However, some teenagers develop a problematic use of the Internet, which is a condition also known by the term of "Internet addiction". In Tunisia, the literature does not report data on problematic Internet use prevalence among Tunisian teenagers. PURPOSE: The aim of this study was to determine the prevalence of problematic Internet use among teenagers, in the urban area of Sfax. METHODS: This transversal study was carried out between the 15th January and the 15th February 2009. Participants were 600, first to third grade secondary school students, aged 14 to 20. They were recruited from seven secondary schools randomly selected in the urban area in Sfax City. The self-administered Young's 8-item questionnaire was used in this survey. Participants who scored five or more can be considered problematic Internet users. Finally, 587 valid data samples were collected, 263 (44%) males and 324 (56%) females. Eighty-five percent of the participants were in the 15-17 age range. The mean age was 16 years (±1.26). RESULTS: The prevalence of problematic Internet use was 18.05% (total of 587 students). The sex-ratio was 0.75. The problematic Internet use was not correlated with sex. The average time of Internet use per day among problematic Internet users was 4.5hours (±2.84) against 1.02hours (±1.56) among non problematic Internet users (P=0.000). DISCUSSION: In this study, the prevalence of problematic Internet use was higher than that reported in previous studies. Two facts can explain this: first, the use of the only self-administered questionnaire does not distinguish between a simple abuse and a problematic Internet use. A psychiatric examination is essential to support the diagnosis of problematic Internet use. Second, this study was conducted exclusively in an urban area where access to the Internet is easier than in rural areas. This study was not representative of teenagers in Sfax. The gender difference was consistent with the findings of prior research, as was the average time of Internet use per day among problematic Internet users. CONCLUSION: This study shows that problematic Internet use is frequent in our teenage population. A preventive outreach for youths, their families and health professionals is needed to limit the extension of this problem among young people. The existence of misuse of the Internet should not lead to avoiding this media. Reflections on how to moderate the relationship with the Internet are necessary; especially since Internet becomes an essential medium of information and communication. The current lack of Internet education in school curricula is also a shortage to fulfil.

[Psychiatric comorbidity related to children with attention deficit hyperactivity disorder at schools in Sfax, Tunisia]. / Comorbidité psychiatrique au trouble déficit de l'attention/hyperactivité en population scolaire dans la région de Sfax. Tunisie : étude transversale.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a prevalent behavioral disorder particularly noticed among school children. It is often associated with other psychological troubles at the origin of an additional difficulty that has to be overcome. OBJECTIVE: Our research's aim was to study the comorbidity of school-aged children diagnosed with ADHD in Sfax, Tunisia. SUBJECTS AND METHODS: A cross-sectional descriptive study was carried out from 1st April 2008 to 1st October 2008. Five hundred and thirteen pupils aged between 6 and 12, from primary arbitrarily chosen schools from Sfax were subjected to this study. Measurements were carried out in two steps: parents and teachers of each child filled in separately Conners questionnaire, then children with a score in subscales inattention, hyperactivity impulsivity higher than 70 were selected for psychiatric interview that was intended to confirm or to invalidate the ADHD diagnosis and the possible comorbid diagnosis. The diagnoses were made according to DSM-IV-TR. RESULTS: We have noticed that 109 pupils exhibited at least one pathological score on the Conners questionnaire. After interviewing these 109 pupils, the results have shown that 51 among them fulfilled criteria of ADHD. Prevalence of ADHD was found to be 9.94 %. About 72.54 % of children with ADHD had one or more comorbid disorder: learning disabilities (23.52 % of cases), anxiety disorder (31.37 % of cases), oppositional defiant disorder in (15.68 % of cases), mood disorder (3.92 % of cases), enuresis (13.72 % of cases) and slight mental retardation (1.95 % of cases). CONCLUSION: We can say that this study has shown that ADHD school children's psychiatric comorbidity is similar to any other previous study.