Obesity Status and Physical Activity Level in Children and Adults with Autism Spectrum Disorders: A Pilot Study.

The purpose of the present study was to compare body composition and physical activity level between children and adults with Autism Spectrum Disorders (ASD). A sample of 78 children, adolescents and adults participated in the study. Anthropometrics and physical activity, using GT1M accelerometer, were assessed. Overweight and obesity prevalence was higher in men vs. male children (p < 0.001) and in men vs. women (p = 0.035). Children recorded more moderate to vigorous physical activity (p = 0.040) than adults. Normal-weight children and adolescents combined as one age group, accomplished more moderate to vigorous physical activity, steps and less sedentary time compared to their overweight and obese counterparts during the weekend. Obesity status may negatively affect physical activity level in ASD individuals.

Sweat sodium loss influences serum sodium concentration in a marathon.

The aim of this investigation was to determine the influence of sweat electrolyte concentration on body water and electrolyte homeostasis during a marathon. Fifty-one runners completed a marathon race in a warm and dry environment (24.4 ± 3.6 °C). Runners were classified as low-salt sweaters (n = 21; <30 mmol/L of sweat Na+ concentration), typical sweaters (n = 20; ≥30 and <60 mmol/L of sweat Na+ concentration), and salty sweaters (n = 10; ≥60 mmol/L of sweat Na+ concentration). Before and after the race, body mass and a sample of venous blood were obtained. During the race, sweat samples were collected by using sweat patches, and fluid and electrolyte intake were recorded by using self-reported questionnaires. Low-salt, typical and salty sweaters presented similar sweat rates (0.93 ± 0.2, 0.92 ± 0.29, 0.99 ± 0.21 L/h, respectively), body mass changes (-3.0 ± 1.0, -3.3 ± 1.0, -3.2 ± 0.8%), total Na+ intake (12.7 ± 8.1, 11.5 ± 9.7, 14.5 ± 16.6 mmol), and fluid intake (1.3 ± 0.8, 1.2 ± 0.8, 1.2 ± 0.6 L) during the race. However, salty sweaters presented lower post-race serum Na+ concentration (140.8 ± 1.3 vs 142.5 ± 1.1, 142.4 ± 1.4 mmol/L; P < 0.01) and serum osmolality (297 ± 6 vs 299 ± 5, 301 ± 6 mOsm/kg; P < 0.05) than low-salt and typical sweaters. Sweat electrolyte concentration could influence post-race serum electrolyte concentration in the marathon. However, even the saltiest sweaters did not develop exercise-associated hyponatremia or associated symptoms.

CFTR genotype-related body water and electrolyte balance during a marathon.

The aim of this investigation was to determine the influence of CFTR genotype on body water and electrolyte balance during a marathon. Fifty-one experienced runners completed a marathon race. Before and after the race, body mass and a sample of venous blood were obtained. During the race, sweat samples were collected using sweat patches, and fluid and electrolyte intake were obtained using self-reported questionnaires. Thirty-eight participants (74.5% of the total) were 7T/7T homozygotes, 11 (21.6%) were 7T/9T heterozygotes, and one participant presented the rare genotype 5T/7T. Another participant with 9T/9T presented the mutation p.L206W. Participants with 7T/7T showed higher sweat sodium concentrations (42.2 ± 21.6 mmol/L) than 7T/9T (29.0 ± 24.7 mmol/L; P = 0.04). The runner with the 5T/7T genotype (10.2 mmol/L) and the participant with the p.L206W mutation (20.5 mmol/L) exhibited low-range sweat sodium concentrations. However, post-race serum sodium concentration was similar in 7T/7T and 7T/9T (142.1 ± 1.3 and 142.4 ± 1.6 mmol/L, respectively; P = 0.27) and did not show abnormalities in participants with the 5T/7T genotype (140.0 mmol/L) and the p.L206W mutation (143.0 mmol/L). Runners with the CFTR-7T/7T genotype exhibited increased sweat sodium concentrations during a marathon. However, this phenotype was not related with increased likelihood of suffering body water and electrolyte imbalances during real competitions.

Effects of oral salt supplementation on physical performance during a half-ironman: A randomized controlled trial.

The aim of this study was to investigate the effectiveness of oral salt supplementation to improve exercise performance during a half-ironman triathlon. Twenty-six experienced triathletes were matched for age, anthropometric data, and training status, and randomly placed into the salt group (113 mmol Na(+) and 112 mmol Cl(-)) or the control group (cellulose). The experimental treatments were ingested before and during a real half-ironman triathlon competition. Pre- and post-race body mass, maximal force during a whole-body isometric strength test, maximal height during a countermovement jump, were measured, and blood samples were obtained. Sweat samples were obtained during the running section. Total race time was lower in the salt group than in the control group (P = 0.04). After the race, whole-body isometric strength (P = 0.17) and jump height (P = 0.49) were similarly reduced in both groups. Sweat loss (P = 0.98) and sweat Na(+) concentration (P = 0.72) were similar between groups. However, body mass tended to be less reduced in the salt group than in the control group (P = 0.09) while post-race serum Na(+) (P = 0.03) and Cl(-) (P = 0.03) concentrations were higher in the salt group than in the control group. Oral salt supplementation was effective to lessen body mass loss and increase serum electrolyte concentration during a real half-ironman.

[Effect of irrigation sequence in vestibular paresis results of bithermal caloric tests]. / Efecto de la secuencia de irrigación en los resultados de la paresia canalicular en la prueba calórica bitérmica.

OBJECTIVE: Bithermal caloric tests are among those most commonly used in vestibular function studies and require a properly systematized approach. Irrigation sequence varies between laboratories. Our objective is to study the effect of irrigation sequence on the percentage of vestibular paresis. MATERIAL AND METHOD: We analysed 1214 records, 77.51% cold to hot sequences (C-H) and the rest hot to cold (H-C). We considered results above 24% of vestibular asymmetry to be pathological. RESULTS: In general, 33.36% of the records were pathological. Groups compared showed that H-C sequence had more significant (P <0.001) pathological results than C-H (46.52% vs 29.54%). CONCLUSION: Irrigation sequence has a significant influence on the outcome of caloric tests to for the detection of vestibular paresis. More studies are needed to confirm the best irrigation sequence.

Efecto de la secuencia de irrigación en los resultados de la paresia canalicular en la prueba calórica bitérmica / Effect of irrigation sequence in vestibular paresis results of bithermal caloric tests

Objetivo: La prueba calórica bitérmica es una de las pruebas más utilizadas para el estudio funcional vestibular. Su realización requiere una adecuada sistematización. La secuencia de realización de las irrigaciones varía de unos centros a otros. Nuestro objetivo es analizar el efecto de las variaciones de la secuencia de irrigación en el porcentaje de paresias canaliculares (%PC). Material y método: Analizamos un total de 1.214 registros; en el 77,51 % practicamos secuencias frías-calientes (F-C) y en el resto, calientes-frías (C-F). Consideramos patológicas respuestas por encima del 24 % de asimetría entre ambos oídos. Resultados: En total, el 33,36 % de los registros resultaron patológicos. Al comparar entre secuencias, las C-F mostraban un %PC significativamente (p < 0,001) superior a las F-C (el 46,52 y el 29,54 %). Conclusiones: La secuencia de irrigación condiciona la capacidad de la prueba para detectar paresias canaliculares. Consideramos necesarios más estudios para establecer cuál es en nuestro medio el método más adecuado

Objective: Bithermal caloric tests are among those most commonly used in vestibular function studies and require a properly systematized approach. Irrigation sequence varies between laboratories. Our objective is to study the effect of irrigation sequence on the percentage of vestibular paresis. Material and method: We analysed 1214 records, 77.51 % cold to hot sequences (C-H) and the rest hot to cold (H-C). We considered results above 24 % of vestibular asymmetry to be pathological. Results: In general, 33.36 % of the records were pathological. Groups compared showed that H-C sequence had more significant (P< .001) pathological results than C-H (46.52 % vs 29.54 %). Conclusion: Irrigation sequence has a significant influence on the outcome of caloric tests to for the detection of vestibular paresis. More studies are needed to confirm the best irrigation sequence

[Diagnosis of common causes of vertigo using a structured clinical history]. / Diagnóstico de causas frecuentes de vértigo mediante historia clínica estructurada.

The structured clinical history is the most sensitive test for diagnosing vertigo. Its diagnostic effectiveness on the first visit was analyzed and key signs and symptoms with high predictive value for common causes of vertigo were identified. One hundred outpatients who complained of dizziness or loss of balance were evaluated using a structured clinical interview. Each questionnaire was examined independently by three blinded investigators, who assigned a diagnosis and identified the elements of the history that figured most prominently in the diagnosis. The gold standard was defined as independent selection of the same diagnostic category by all three investigators. A first-visit diagnosis was obtained in 40% of patients (95% confidence interval 30-50%): 38% women and 42% men. Causes included benign positional paroxysmal vertigo (BPPV, 13 patients), headache-associated vertigo (9), Meniere disease (7), cervical vertigo (3), psychiatric dizziness (2), post-traumatic vertigo (2), vertebro-basilar transient ischemic attack (1), vestibular neuritis (1), convulsive seizure (1), and presyncope (1). The best predictors of BPPV were the precipitating mechanism (specificity [SP] 100%), positional nystagmus (sensitivity [SE] 90%, SP 63%), and the Dix-Hallpike test (SE 82%, SP 71%). Elements predictive of headache-associated vertigo were duration of the attack (minutes) and a personal history of headache (both, SP 100%). Other predictors were facial hypoesthesia (SE 92%, SP 47%) and associated neurological disease (SE 82%, SP 58%).

High frequency of altered HLA class I phenotypes in laryngeal carcinomas.

The exact frequency of HLA class I losses in human tumors is unknown. We have previously shown that primary breast and colorectal carcinomas frequently lose HLA class I molecules (88% and 73%, respectively). Now we report that this phenomenon is also a frequent event in laryngeal carcinomas. Of a total of 76 laryngeal carcinomas analyzed, 66% of the tumors showed an alteration in HLA class I phenotype. These altered HLA phenotypes were classified as total HLA loss (10.52%) (phenotype I); HLA-A locus-specific loss (13.15%) (phenotype IIIa); HLA-B locus-specific loss (10.52%) (phenotype IIIb); HLA allelic loss (27.63%) (phenotype IV); and HLA-A and B locus loss (3.9%). Comparison of histopathological parameters with HLA expression showed that poorly differentiated tumors had the lowest levels of HLA class I expression (p < 0.05).

Diagnóstico de causas frecuentes de vértigo mediante historia clínica estructurada / Diagnosis of common causes of vertigo using a structured clinical history

La historia clínica estructurada es el test de mayor sensibilidad para el diagnóstico de vértigo. Se analiza su eficacia diagnóstico en la primera visita, identificándose los signos y síntomas clave que presentan un elevado valor predictivo para las causas comunes de vértigo. Cien pacientes ambulatorios cuyo síntoma principal era desequilibrio o mareo fueron evaluados mediante entrevista clínica estructurada. Cada cuestionario fue evaluado de forma ciega por 3 investigadores que asignaron un diagnóstico y los elementos de la historia que más contribuyeron a seleccionar ese diagnóstico. El estándar ideal se definió como la selección independiente de la misma categoría diagnóstica por los 3 investigadores. En la primera visita, se obtuvo un diagnóstico en el 40 por ciento (intervalo de confianza al 95 por ciento, 30-50 por ciento): 38 por ciento de mujeres y 42 por ciento de hombres. Las causas fueron vértigo posicional paroxístico benigno (VPPB, 13 pacientes), vértigo asociado a cefalea (9 pacientes), Enfermedad de Méniére (7), vértigo cervical (3), trastorno del equilibrio de origen psíquico (2), vértigo post-traumático (2), accidente isquémico transitorio vértebro-basilar (1), neuritis vestibular (1), crisis convulsiva (1) y presíncope (1). Los factores predictivos para VPPB fueron el mecanismo desencadenante (especificidad [El 100 por ciento), el nistagmo posicional (sensibilidad [S] 90 por ciento, E 63 por ciento) y el test de Dix- Halipike (S 82 por ciento, E 71 por ciento). Los factores predictivos para el vértigo asociado a cefalea fueron la duración de la crisis de minutos y el antecedente de cefalea (E 100 por ciento). Otros factores predictivos fueron la hipoestesia facial (S 92 por ciento, E 47 por ciento) y la presencia de enfermedad neurológica asociada (S 82 por ciento, E 58 por ciento) (AU)

The structured clinical history is the most sensitive test for diagnosing vertigo. Its diagnostic effectiveness on the first visit was analyzed and key signs and symptoms with high predictive value for common causes of vertigo were identified. One hundred outpatients who complained of dizziness or loss of balance were evaluated using a structured clinical interview. Each questionnaire was examined independently by three blinded investigators, who assigned a diagnosis and identified the elements of the history that figured most prominently in the diagnosis. The gold standard was defined as independent selection of the same diagnostic category by all three investigators. A first-visit diagnosis was obtained in 40% of patients (95% confidence interval 30-50%): 38% women and 42% men. Causes included benign positional paroxysmal vertigo (BPPV, 13 patients), headache-associated vertigo (9), Meniere disease (7), cervical vertigo (3), psychiatric dizziness (2), post-traumatic vertigo (2), vertebro-basilar transient ischemic attack (1), vestibular neuritis (1), convulsive seizure (1), and presyncope (1). The best predictors of BPPV were the precipitating mechanism (specificity [SP] 100%), positional nystagmus (sensitivity [SE] 90%, SP 63%), and the Dix-Hallpike test (SE 82%, SP 71%). Elements predictive of headache-associated vertigo were duration of the attack (minutes) and a personal history of headache (both, SP 100%). Other predictors were facial hypoesthesia (SE 92%, SP 47%) and associated neurological disease (SE 82%, SP 58%) (AU)

[The treatment of benign paroxysmal positional vertigo of the lateral semicircular canal by positional manipulation]. / Tratamiento del vértigo posicional paroxístico benigno del conducto semicircular lateral mediante maniobra posicional.

A case of left horizontal-canal benign paroxysmal positional vertigo (HC-BPPV) in a woman with a 7-year history of episodic vertigo when turning over in bed is reported. The diagnosis was established with the patient lying down with her head raised 30 degrees with respect to the horizontal plane. Treatment with positional maneuvers (270 degrees contralateral head rotation in 3 steps) resolved the attacks. Positional testing failed to elicit symptoms 7 days, 14 days, 1 month, and 2 months after treatment. Four months after treatment, the patient remains asymptomatic. Published cases of HC-BPPV are discussed, as well as the differential diagnosis with posterior semicircular canal BPPV.

[Meta-analysis of the treatment of benign paroxysmal positional vertigo by Epley and Semont maneuvers]. / Metaanálisis del tratamiento del vértigo posicional paroxístico benigno mediante maniobras de Epley y Semont.

OBJECTIVE: To determine the effectiveness of Epley and Semont maneuvers in treating benign paroxysmal positional vertigo (BPPV). DESIGN: Systematic search of the medical literature to identify studies that used Epley or Semont maneuvers in randomized controlled trials to treat BPP'V. Studies were examined blind and the results of the studies with a satisfactory methodological quality were pooled. SUBJECTS: Four studies of adults with a clinical diagnosis of BPPV. MAIN OUTCOME MEASURES: Subjective sensation of vertigo 7 and 30 days after treatment, positional objective nystagmus and vertigo evoked by the Dix-Hallpike test (DHT) 7 and 30 days after treatment. RESULTS: Seventy percent of Epley maneuver-treated adults and 95% of placebo-treated adults reported new episodes of vertigo at 7 days. Moreover, 100% had a positive DHT (odds ratio 0.11; p = 0. 0072). However, 30 days after treatment 59% of treated adults (Epley or Semont) remained asymptomatic and 89% were unresponsive to DHT. Subjective remission of BPPV occurred in 47% of placebo-treated subjects, but only 27% had a negative DHT (odds ratio 0.05 for Epley maneuver-treated evaluated by DHT). CONCLUSIONS: The Epley canalith repositioning procedure or Semont maneuver had a significantly higher efficacy rate in patients with BPPV than placebo procedures, but results must be evaluated at 30 days by DHT. DHT is an easy, low-cost and effective method for assessing the outcome of treatment in patients with BPPV.

Cervical metastasis of occult papillary thyroid carcinoma associated with epidermoid carcinoma of the larynx.

An occult, laterocervical papillary thyroid carcinoma tissue was found in a functional neck dissection for larynx cancer. The patient was a 76-year-old man with a history of smoking and alcohol ingestion who presented with a supraglottic carcinoma of the larynx located at the laryngeal surface of the epiglottis, left aryepiglottic fold, band and left ventricle with extension to the left vocal cord. Light microscopy showed a lymph node with a fibrous stroma with lymphoid follicles that presented a total substitution of the parenchyma by a papillary thyroid carcinoma. Although examination of the thyroid gland by seriated sections did not reveal any neoplasm, we argue that the papillary thyroid tissue is metastatic.

Age and sex differences in latencies of waves I, III and V in auditory brainstem response of normal hearing subjects.

Latencies of auditory brainstem response are known to be affected by age and sex. We have investigated the effects of age and sex on absolute latencies of waves I, III and V, the interpeaks intervals I-V, I-III and III-V for left and right ears in 67 healthy subjects with normal hearing. We evaluated the reproducibility of the response between ears which showed consistent data. Latency-intensity plots for waves I, III and V were compared among men and women by estimating the regression equations, with no significant difference in the slopes. Regression analysis revealed that latencies of waves I and V were increased with age in men from childhood up to fifties, according to a linear function. However, in women latencies were not dependent on age. The intervals I-V, I-III and III-V were independent on age for both men and women. The latencies of waves III and V and the I-III and I-V intervals were significantly shorter in women than in men in both ears. The findings obtained in the present study show that gender have a stronger effect on latencies of waves III and V, shortening the I-III and I-V intervals in women. Moreover, latencies of waves I and V increase with age in men.