Infertility treatment and autism risk using the Modified Checklist for Autism in Toddlers (M-CHAT).

STUDY QUESTION: Are toddlers conceived by fertility treatment at higher risk of failing a screening tool for autism spectrum disorders (ASD) than toddlers not conceived by treatment? SUMMARY ANSWER: Compared with children not conceived by infertility treatment, children conceived by any infertility treatment, ovulation induction with or without intrauterine insemination (OI/IUI), or assisted reproductive technologies (ART) appeared to have had higher odds of failing an ASD screening; however, results were inconclusive and need replication. WHAT IS KNOWN ALREADY: Although most of the studies which have examined risk of ASD after ART show no association, the results are mixed. Thus, further studies are needed to clarify this association. STUDY DESIGN SIZE, DURATION: The Upstate KIDS Study is a population-based, prospective cohort study of children born in New York State between 2008 and 2010. Children were screened for ASD using the Modified Checklist for Autism in Toddlers (M-CHAT) at ages 18 and 24 months. PARTICIPANTS/MATERIALS, SETTING, AND METHODS: The New York State live-birth registry was used to identify newborns conceived with and without fertility treatment with a 1:3 ratio, frequency matched on region of birth. At 18 and 24 months, 3183 and 3063 mothers, respectively, completed the M-CHAT questionnaire. The current analysis included 2586 singletons and 1296 twins with M-CHAT information at 18 and/or 24 months. Multivariable logistic regression with generalized estimating equations (GEE) was used to estimate odds ratios (aOR) and 95% confidence intervals (CI) after adjustment for covariates such as maternal age, education and plurality. MAIN RESULTS AND THE ROLE OF CHANCE: We found that 200 (5.2%) and 115 (3.0%) children failed the M-CHAT at 18 and 24 months, respectively. The associations between use of infertility treatment and failing the M-CHAT at 18 and/or 24 months were positive but inconclusive as they failed to exclude no association (18 months aOR 1.71, 95% CI: 0.81-3.61; 24 months aOR 1.78, 95% CI: 0.66-4.81; and both 18 and 24 months aOR 1.53, 95% CI: 0.78-2.99). The relationships between OI/IUI and ART with M-CHAT failure at 18 and/or 24 months were similar to those of using any fertility treatment. In vitro fertilization with intracytoplasmic sperm injection was not consistently positively or inversely associated with M-CHAT failure at each time point (18 months aOR 1.20, 95% CI: 0.51-2.83; 24 months aOR 0.93, 95% CI: 0.37-2.31; and both 18 and 24 months aOR 1.09, 95% CI: 0.50-2.60). LIMITATIONS REASONS FOR CAUTION: The M-CHAT is a screening tool used for ASD risk assessment, and therefore, M-CHAT failure does not indicate ASD diagnosis. In addition, we did not have power to detect associations of small magnitude. Finally, non-response to follow-up may bias the results. WIDER IMPLICATIONS OF THE FINDINGS: Despite lack of precision, the positive associations between ART and M-CHAT failure suggest that larger population-based studies with longer follow-up are needed. STUDY FUNDING/COMPETING INTEREST(S): Supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; contracts HHSN275201200005C, HHSN267200700019C). The sponsor played no role in the study design, data collection, data analysis or interpretation, writing of the manuscript or decision to submit the article for publication. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: Not applicable.

Cuidados iniciais à saúde na perspectiva cultural: produção científica sobre o tema / Initial health care under cultural perspective: scientific production about this topic

Objetivo: analisar os estudos existentes e disponíveis sobre cuidados iniciais à saúde, na perspectivacultural. Métodos: revisão integrativa da literatura cujo delineamento é qualitativo e descritivo,realizada a busca em julho de 2014, nas Bases de dados e no Banco de teses da Coordenação deAperfeiçoamento de Pessoal Nível Superior, sendo que após a aplicação dos critérios de seleçãorestaram 19 publicações. Resultados: o país com maior número de publicações é o Brasil, porém aspesquisas sobre a temática estão presentes nos cinco continentes, embora as produções ainda sejampouco expressivas. A análise das produções referente aos cuidados iniciais à saúde dentro de umaperspectiva cultural, dentre os cuidados elencados estão às terapias complementares. ConsideraçõesFinais: estes achados apontam para a importância do profissional de saúde atuar considerando ocontexto cultural que envolve as práticas de cuidados iniciais à saúde.

Objective: to analyze existing and available studies on early health care from a cultural perspective.Methods: integrative review whose delineation is qualitative and descriptive, carried out the searchin July 2014, in the Databases and in the Thesis Bank of the Coordination of Improvement of Higher Education Personnel, and after the application of the selection criteria, there were 19 publications.Results: the country with the largest number of publications is Brazil, but research on the subjectis present in five continents, although the productions are still not very expressive. The analysis ofthe productions related to the initial health care from a cultural perspective, among the listed careare complementary therapies. Final considerations: these findings point to the importance of thehealth professional to act considering the cultural context that involves the initial health carepractices.

Epidermal-skin-test 1,000 (EST-1,000)--a new reconstructed epidermis for in vitro skin corrosivity testing.

The determination of a possible corrosive or irritative potential of certain products and ingredients is necessary for their classification and labeling requirements. Reconstructed skin as a model system provides fundamental advantages to single cell culture testing and leads to promising results as shown by different validation studies (for review: Fentem, J.H., Botham, P.A., 2002. ECVAM's activities in validating alternative tests for skin corrosion and irritation. ATLA 30(Suppl. 2), 61-67). In this study we introduce our new reconstructed epidermis "Epidermal-Skin-Test" (EST-1,000). This fully grown epidermis consists of proliferating as well as differentiating keratinocytes. EST-1,000 shows a high comparability to normal human skin as shown by histological and immunohistochemical data. Characteristic markers (KI-67, CK 1/10/5/14, transglutaminase, collagen IV, involucrin, beta 1 integrin) can be identified easily. The main focus of this work was to characterize EST-1,000 especially with respect to its barrier function by testing several substances of known corrosive potential. Skin corrosion was detected by the cytotoxic effect of the substances on a reconstructed epidermis after short-term application to the stratum corneum. The effect was determined by standard MTT assay and accompanying histological analysis. Hence EST-1,000 shows a very high predictive potential and closes the gap between animal testing and the established full-thickness model Advanced-Skin-Test 2,000 (AST-2,000) (Noll, M., Merkle, M.-L., Kandsberger, M., Matthes, T., Fuchs, H., Graeve, T., 1999. Reconstructed human skin (AST-2,000) as a tool for pharmaco-toxicology. ATLA 27, 302).

Computer intuition: guiding scientific research in imaging and oral implantology.

As the costs associated with clinical research and new drug development increase, it is incumbent upon us to develop alternative research methodologies. A new Computer Intuition (CI) program identifies literature-based evidence with the potential to generate a hypothesis that is most likely to be clinically confirmed regarding the cause of a disease or the questions being posed. The objective of this study was to demonstrate whether computer intuition can be used to guide scientific research in solving important biomedical questions. The establishment of CI as an alternative research methodology has the potential to accelerate the translation of basic science findings into clinical practice. The specific aim of this study was to develop a CI-driven hypothesis related to the controversial issue debating which radiographic imaging technology is most suitable for diagnostic purposes prior to the placement of oral implants. This hypothesis was then compared, in retrospect, with a known opinion established following a recent literature review on this issue. In his review of the literature, Frederiksen (1995) suggests that multiplanar reformatted computed tomography (CT) is the diagnostic imaging modality of choice prior to implant placement. To compare the CI hypothesis with Frederiksen's (1995) opinion, we subjected 34 relevant papers to CI analysis. The output consisted of clusters of important statements, phrases, and thought processes from the given dataset rated with the greatest potential to generate testable hypotheses. Both CI's output and Frederiksen (1995) indicated that CT scanning is the diagnostic imaging modality of choice prior to implant placement. Although the ultimate utility of CI is dependent on the successful testing of its derived hypothesis, this preliminary retrospective study suggests that CI might be useful in guiding scientific research.

An in vitro control mechanism for potato stress metabolite biosynthesis.

Ethylene/oxygen (E/O(2)) elevates sesquiterpenoid stress metabolite (SSM) levels in potato (Solanum tuberosum L.) tuber tissue which is reacting hypersensitively. To determine whether E/O(2) retards SSM turnover, a measured amount of rishitin was applied to tuber tissue which was then incubated in air or E/O(2), and rishitin disappearance was monitored. No difference in the rate of rishitin disappearance was detected between air and E/O(2) incubations. However, tissue treated with rishitin and incubated in E/O(2) accumulated intermediates of the katahdinone and phytuberin pathways. This was not the case in rishitin-air treatments. These results suggest the dual involvement of ethylene and SSM intermediates in the regulation of the biosynthesis of SSM, compounds which may serve as phytoalexins.

Effects of Controlled Atmospheres on Production of Sesquiterpenoid Stress Metabolites by White Potato Tuber: Possible Involvement of Cyanide-resistant Respiration.

Levels of katahdinone (solavetivone), lubimin, rishitin, and phytuberin, sesquiterpenoid stress metabolites of white potato (Solanum tuberosum), were monitored in tuber slices which were challenged with an extract of Phytophthora infestans and incubated under controlled atmospheres. A mixture of ethylene in air enhanced stress metabolite production. This enhancement was amplified by higher partial pressures of oxygen. Stress metabolite production was inhibited by salicylhydroxamic acid. These results suggest the involvement of cyanide-resistant respiration in the production of potato stress metabolites, compounds which may serve as phytoalexins.

1-(Theophyllin-7-yl)-ethyl-2-[2-(p-chlorophenoxy)-2-methylpropionate] (ML 1024), a new hypolipemic agent.

1-(Theophyllin-7-yl)-ethyl-2-[2-(p-chlorophenoxy)-2-methylpropionate] (ML 1024) was tested on acute and chronic toxicity, on teratogenesis and fetotoxicity, on blood pressure and blood flow behaviour, on hypolipemic activity and general pharmacological behaviour in a screening test using 54 parameters. Results warrant further investigation of the potential therapeutic application of ML 1024 in humans based on its superiority to the well-known antilipemic clofibrate (CPIB).