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Early Treatment May Decrease Autism Signs

By Geoffrey Mohan, Los Angeles Times

LOS ANGELES — How early can autism be detected in babies, and how soon can they be treated?

A baby’s first birthday visit to the pediatrician usually includes a screening for the social deficits common with autism spectrum disorder. But doctors and scientists tend to agree that they can’t make a very reliable diagnosis until the toddler is 2 years old. The bulk of treatment programs begin then.

Several recent studies, however, have documented subtle signs of the disorder, including erratic eye motion, among infants as young at 2 months old. That and other behavioral differences become more noticeable between 6 months and a year of age, other studies have shown.

Researchers at the University of California, Davis’ MIND Institute have been watching and playing with babies for many years to study autism and other development issues. This time, researchers set out to test whether they could accurately identify early signs associated with autism, and whether parents would be willing and able to follow directed therapy aimed at improving interaction with their babies. And if they did, would it help?

The study, published online Tuesday in the Journal of Autism and Development Disorders, suggests a qualified yes on all counts. The data from the pilot program jibe with a growing body of research that shows that guided social interaction between a mother and her baby can decrease autism symptoms by age 3.

The babies whose parents underwent the coaching showed far fewer autism-related measures at 3 than peers whose parents declined to participate, even though their infants met all criteria. Infants in the training program also scored higher than non-participants who later were diagnosed with autism, the study found.

“It gives us a little hint that the children may well have gone on to have more difficulties had we not done this intervention early,” said lead investigator Sally J. Rogers, a developmental psychologist at the MIND Institute. “But it’s only a hint, not proof.”

The sample of the pilot study was small — just seven babies from UC Davis programs or the community underwent training, and babies were not assigned randomly to different treatments. So, results will have to withstand more rigorous testing.

In some ways, the study was as much a test for parents as for babies. Researchers wanted to know whether mothers could be professionally coached to maximize opportunities to connect with babies who often don’t make eye contact and can exhibit repetitive behaviors and become obsessed with a single toy or other object. These and other symptoms had been identified among study subjects through the Autism Observation Scale for Infants and other clinical measures.

“These were very atypical infants, and everyone who interacted with them recognized that,” Rogers said. “So I do think we found a group of children who had very atypical social communication development.”

Mothers (with their babies) went through 12 weekly one-hour training and observation sessions with professional therapists. Several families received “booster” sessions or were referred to extra therapy, such as speech coaching. Babies underwent regular developmental testing, usually at intervals of three months, until they were 36 months old.

Control groups were culled from 126 infants enrolled at the MIND Institute’s Infant Sibling project, which studies the development trajectory of siblings of children with autism diagnoses.

Photo via WikiCommons

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Finding The Best Doctor Can Be Difficult

Whether for routine care or a special situation or condition, it can be difficult to find the right doctor.  And finding the best in a particular field is even a bigger crap shoot.

Conventional wisdom dictates that the best way to find a specialist is from your primary care doctor, another health professional, or a referral from someone who has had a good experience. Of course sometimes that’s not possible, so many people turn to various top-doctor directories for answers. Unfortunately, some of the information contained in those sources is not exactly accurate.  According to The New York Times each source uses a different method to come up with their list.  Believe it or not, some just use phone directories; others poll actual doctors to get the names of whomever they consider tops in their field; and some use patient reviews.

“In fact, nobody knows who the top doctors are, not even the doctors themselves. It is safe to say that the very topmost doctors, confusingly, are probably not top doctors. They have become media stars and household names through efforts that presumably leave them little time to hone those top-doctor skills.”

Photo: Pixabay.com

Ex-Doctor Gets Almost 6 Years For Craigslist Sex-Drugs Scheme

By Marwa Eltagouri, Chicago Tribune

CHICAGO — A former doctor was sentenced Tuesday to nearly 6 years in prison for trading prescription narcotics for sex on Craigslist.

In imposing the 5-year, 10-month sentence, U.S. District Judge Rebecca Pallmeyer called the wrongdoing by Joshua D. Baron “very serious and disturbing.”

“Mr. Baron was purchasing sexual favors for the drugs he knew people were addicted to and would do anything for,” the judge said.

Baron, who pleaded guilty in March to victimizing 16 individuals over a five-year period, apologized to his family, the court, and the community.

“I regret the embarrassment I’ve brought to my children,” he said in a shaky voice. “I apologize that their father is not truly a man they can fully look up to.”

Baron’s guilty plea came about three years after suburban Chicago authorities arrested him for attempting to trade drugs for sex with an undercover police officer.

Baron admitted in his plea that he provided thousands of doses of controlled substances to 16 individuals between 2006 and 2011 in exchange for sex and money. Baron would post advertisements offering to trade the prescription drugs on Craigslist, authorities said.

Authorities said Baron dispensed a total of 3,420 Adderall and Xanax pills, along with a host of other painkillers and controlled substances.

The individuals Baron made the exchanges with were never his patients, federal authorities said.

Baron was initially charged in January 2011 after a sting conducted by the Wilmette Police Department. He was charged federally in October of that year after a broader investigation by the Drug Enforcement Administration and Chicago Police Department, federal authorities said.

Baron was suspended from his job at Rush University Medical Center in Chicago after his arrest. His work focused on epilepsy and had ongoing trials in examining sleep symptoms in children with epilepsy, as well as studies to evaluate novel pharmaceuticals, the hospital’s website said.

Baron’s plea agreement provides for a sentencing recommendation of nine to 11 years in prison, authorities said.

Federal authorities said Baron voluntarily surrendered his medical license and federal drug registration in 2011.

Photo: Chika via Flickr

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Way Too Many Doctors Are Prescribing Antibiotics In Error, Study Says

By Karen Kaplan, Los Angeles Times

About 7 in 10 patients who go to a doctor seeking treatment for acute bronchitis wind up leaving their appointment with a prescription for an antibiotic, according to a new study in the Journal of the American Medical Association. That’s a problem, the study authors say, because the ideal prescription rate should be 0 percent.

That’s right, a big fat zero. Zip. Nada. Zilch.

More than 40 years of clinical trials have demonstrated that antibiotics do not help patients with acute bronchitis. On top of that, the Centers for Disease Control and Prevention have been emphasizing this fact for the last 15 years, as has the Healthcare Effectiveness Data and Information Set for nearly 10 years, the JAMA report says.

But it doesn’t seem that the message has gotten through to doctors. Not only are physicians continuing to write prescriptions for the medications, but they also did it more frequently in 2010 than they did in 1996, the study authors found.

Researchers from Brigham and Women’s Hospital in Boston analyzed data from two national surveys that track patients who are seen in medical clinics (including pediatric practices) or in hospital emergency departments. Records between 1996 and 2010 identified 3,153 patients whose only medical complaint was acute bronchitis, a respiratory disease that makes people cough and is over in less than three weeks. (Patients who also had other problems, including chronic pulmonary disease or infectious diseases, were excluded from the analysis.)

During the entire study period, 36 percent of those patients got a prescription for an extended macrolide, a group that includes such workhorses as azithromycin and erythromycin. Another 35 percent got an Rx for a broad-spectrum antibiotic, including fluoroquinolones, aminopenicillins and cephalosporins. Altogether, the antibiotic prescription rate was 71 percent, the researchers found.

Use of the broad-spectrum drugs fell slightly during the study period, though the difference wasn’t large enough to be statistically significant, the researchers reported. However, there was a distinct rise in the use of extended macrolides, with the prescription rate increasing from 25 percent between 1996 and 1998 to 41 percent between 2008 and 2010, according to the study.

Over the 14 years of the study, 72 percent of doctors in primary care practices gave their patients some kind of antibiotic for acute bronchitis. So did 69 percent of the doctors treating patients in hospital emergency departments. Both groups of physicians seemed to lay off the drugs a little bit between 1999 and 2001, but that trend didn’t last.

The study authors sounded somewhat exasperated about the fact that a figure that should be 0 percent was actually 71 percent. “Avoidance of antibiotic overuse for acute bronchitis should be a cornerstone of quality health care,” they wrote.

The CDC and other health groups are concerned that the overuse of antibiotics is helping to fuel the rise in drug-resistant pathogens, including strains of tuberculosis, Staphylococcus aureus and E. coli. This month, one of the World Health Organization’s top officials for health security warned that “the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill.”

“Effective antibiotics have been one of the pillars allowing us to live longer, live healthier and benefit from modern medicine,” said Dr. Keiji Fukuda, who led a report on the state of antimicrobial resistance around the world. “Unless we take significant actions … the implications will be devastating.”

Photo via Flickr