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  • June 27, 2014
  • 12:00 PM


by Lucy Gee in Antisense Science

In the world food has always been a necessity, but for most it represents a ritual, a pleasure, our culture. For many of us it’s synonymous with celebration and often associated with some of the happier moments in our lives – but do we need it? One man, Rob Rhinehart has embarked on a new life, without the need for solid food. He has created a product named Soylent (I know what you’re thinking, like that sci-fi book right? We’ve all heard of Soylent Green), which is an entire food replacement powder. Just mix this in with water and a few vitamin supplements and you’re good to go; you never have to eat again. But does it work? Is it safe? Is this the future of food?
... Read more »

Epstein LH, Carr KA, Cavanaugh MD, Paluch RA, & Bouton ME. (2011) Long-term habituation to food in obese and nonobese women. The American journal of clinical nutrition, 94(2), 371-6. PMID: 21593492  

  • June 27, 2014
  • 05:08 AM

Scurvy, vitamin C and autism

by Paul Whiteley in Questioning Answers

I'd been thinking about writing this post on scurvy, vitamin C and autism for quite a while. The paper by Kitcharoensakkul and colleagues [1] really made the decision for me, following their discussions on three young children with walking difficulties who were eventually diagnosed with scurvy, one of whom was diagnosed with autism. The authors concluded: "These clinical manifestations and radiologic findings highlight the importance for rheumatologists to have a higher index of suspicion for scurvy in nonambulatory children". Nonambulatory by the way, means not able to walk about (independently). "Interestingly, all patients had concomitant vitamin D deficiency" was another important point made in the Kitcharoensakkul study which is something I'm always a little interested in on this blog (see here).Limes... @ Fludkov @ Wikipedia Scurvy, as some people might already know, is a condition characterised by a lack of sufficient vitamin C (ascorbic acid). It can manifest in a variety of ways including fatigue, lack of appetite, irritability alongside various functional gastrointestinal (GI) symptoms. Gingival swelling or bleeding (the gums) is perhaps one of the best known [oral] signs of the disease. Nowadays it is quite a rare condition.In other blog entries I've referred to myself as a Limey reflective of a slang phrase for someone from these hallowed Isles called Great Britain (Britain, Britain, Britain..), which seems to derive from the practice of giving lime juice to British sailors way back when, to prevent scurvy.Suffice to say however that the Kitcharoensakkul paper is not the first time that scurvy has appeared alongside the word autism or words autism spectrum disorder (ASD) as I'll attempt to show you...Case studies describing scurvy concurrent to a diagnosis of autism can be found in the peer-reviewed research literature [2]. The description by Mawson [3] is typical although some symptoms reported in that particular case as being perhaps complicated by "treatment with indomethacin, which lowers vitamin C levels" is an important addition. I do think it is important to raise the point that some medicines can interfere with the availability of things like vitamins and minerals similar to such nutraceuticals affecting some medicines.Cole and colleagues [4] talked about the continued presence of scurvy "among susceptible populations" which includes "certain unique populations-particularly the elderly subjects, patients with neurodevelopmental disabilities or psychiatric illnesses, or others with unusual dietary habits" in their report on a "10-year-old autistic child". 'Unusual' dietary patterns are no stranger to autism [5] (open-access here) over and above any special dietary regimes being implemented (see here).Congidi and colleagues [6] described another case of scurvy in "an autistic child with food-avoidant behavior". They also described MRI findings for their patient. Indeed, this is something also described in the report by Tetsu and colleagues [7] who reported that the: "imaging findings of the thigh showed diffuse signal abnormality in the bone marrow, periosteum, and the femoral muscle". Further: "A biopsy specimen of the femur showed hematoma, proliferative fibroblasts, and few collagen fibers, which suggested a deficiency of vitamin C".Slightly outside of the issue of scurvy is the study presented by Dolske and colleagues [8] "exploring the effectiveness of ascorbic acid (8g/70kg/day) as a supplemental pharmacological treatment for autistic children in residential treatment". Although this was a small trial in terms of participant numbers, it was a "double-blind, placebo-controlled trial" lasting 30 weeks. The authors reported "a reduction in symptom severity associated with the ascorbic acid treatment" making specific mention of "sensory motor scores". Obviously I'm not making any recommendations about these findings (no medical or clinical advice given or intended) but do find them to be interesting and perhaps overlapping with other research where vitamin C supplementation has been included. So, think back to the Jim Adams trial data (see here) based on some older research [9]. As to the hows and whys, well, unlike the chatter about vitamin C therapy potentially impacting on Epstein-Barr antibodies no biological measure was used in the Dolske study so we are left speculating...As you've probably realised, most of the research evidence surrounding the presence of scurvy in cases of autism is based on individual case reports. I can't for example, provide you with any population estimates of how prevalent scurvy might be in cases of autism because no-one has really looked at this issue with any great assiduity. I can point you in the direction of other work talking again about cases of scurvy appearing alongside schizophrenia for example [10] but will only say that a poor diet lacking in sources of vitamin C is as much to blame in those examples as it probably is where cases of autism are discussed.Just before I go, there are a few other things to note about vitamin C and autism which may also be pertinent to other issues. I've talked about iron before on this blog and how there is some data suggesting issues with iron for some on the autism spectrum (although certainly not all). It's quite long been recognised that vitamin C also plays a role in the absorption of iron [11] particularly non-heme iron sources and a deficiency in vitamin C is probably not going to be conducive to 'optimal' function. Quite a while back I also talked about autism and oxalates (see here) but will say no more than re-iterating the study by Chai and colleagues [12] with the requirement for lots more investigation in this area.To close, I was saddened to hear of the death of Prof. Paul Patterson this week, a real research pioneer who's studies on autism and schizophrenia were frequently discussed on this blog (... Read more »

Kitcharoensakkul M, Schulz CG, Kassel R, Khanna G, Liang S, Ngwube A, Baszis KW, Hunstad DA, & White AJ. (2014) Scurvy revealed by difficulty walking: three cases in young children. Journal of clinical rheumatology : practical reports on rheumatic , 20(4), 224-8. PMID: 24847751  

  • June 26, 2014
  • 01:42 PM

Finally, a better Battery!

by Gabriel in Lunatic Laboratories

You know what technology hasn’t been able to keep pace with us? Well besides whatever tech the DMV uses, it’s batteries. Think about it, they are nasty, make a mess, are hazzardous, hard to recycle and weigh a freaking ton compared to the energy stored. Current battery technology is my number one problem with electric cars as it stands now. Between the weight, the resources, and the waste, electric cars are almost a wash. Not quite mind you, but almost.... Read more »

  • June 26, 2014
  • 11:20 AM

Does the wire matter?

by Kevin OBrien in Kevin OBrien's Orthodontic Blog

Does the wire matter? This blog is about wire. I thought that I should illustrate it with an orthodontic wire sculpture from the University of Washington. Each year the residents hold a competition on who can construct the best sculpture and this was the winner several years ago. When I wrote last weeks blog, I […]
The post Does the wire matter? appeared first on Kevin O'Brien's Orthodontic Blog.
... Read more »

  • June 26, 2014
  • 04:44 AM

Increased rates of suicidal ideation in adults with Asperger syndrome

by Paul Whiteley in Questioning Answers

"Our findings lend support to anecdotal reports of increased rates of suicidal ideation in adults with Asperger's syndrome, and depression as an important potential risk factor for suicidality in adults with this condition".Sunrise @ Wikipedia That was the very stark conclusion reached by the study by Sarah Cassidy and colleagues [1] (open-access) looking at self-reported rates of suicide ideation and suicide plans/attempts in a sample of adults newly diagnosed with Asperger syndrome attending a "specialist diagnostic clinic" between 2004 and 2013. That depression seemed to play an important role in the engagement of such extreme thoughts or behaviour was also important. The press release accompanying the research can be read here.As per some previous discussion on this topic (see here), suicide, whether attempted or completed, is a difficult topic to talk about. Not only because of the emotions which it invariably stirs up but also because the various paths towards someone reaching such an extreme point are complex, often very individual and still not well understood. Among the various risk factors suggested to be linked to [completed] suicide [2] some key points quite consistently come out including (a) a previous history of suicide ideation or suicide attempts, (b) the presence of psychiatric comorbidity such as depression or psychotic illness, and (c) some degree of social exclusion or alienation. I should mention that this is not an extensive list of risk factors, merely those which seem to appear with greatest frequency in the various research literature in this area.The Cassidy paper is open-access but a few points are pertinent:As part of their attendance at clinic, nearly 400 adults ranging in ages from 17 - 67 years old at time of diagnosis, completed a self-report "patient screening questionnaire" containing items of about suicide and mood. The paper states the relevant questions: "have you ever been diagnosed with depression?", "have you ever felt suicidal?" and "if yes, have you ever planned or attempted suicide?".Participant were also asked to complete the Empathy Quotient (EQ) and the Autism Spectrum Quotient (AQ) questionnaires, both self-report measures which provide information about empathy and some of the "cognitive-behavioural traits associated with autism". Data derived from the suicide questioning items were compared with "published rates of suicidal ideation in the general population and other clinical groups".Results: "a 66% lifetime experience of suicidal ideation and a 35% lifetime experience of planned or attempted suicide supports the assertion that these occurrences are common in people with Asperger's syndrome". Compared with the population control data on these issues, the authors report that their sample were "more likely to report lifetime experience of suicidal ideation than were individuals from a general UK population sample". This included those with medical illnesses or psychotic illness. But... those with drug dependency and ADHD were still marginally more likely to report suicide ideation.Depression also seemed to play it's part in the reports. "Individuals with a history of depression ... were more likely to report suicide ideation ... and more likely to report suicide plans or attempts" compared with those without depression. And as for the EQ and AQ data, well higher scores on the AQ seemed to link with those reporting suicide plans or attempts but that was about it.There are limitations to this study based on issues like the use of self-report questionnaire items asking about things like planned or attempted suicide or depression diagnosis without other evidence sources. Also as the authors note, their focus on "the population of people who reach adulthood without a diagnosis of Asperger's syndrome" is relevant. But the results are pretty stark particularly in respect to the numbers who have actually planned or attempted suicide. Going back to those more generalised population risk factors linked to suicide ideation or completion, it's not difficult to see how many of those might especially apply to some diagnosed with Asperger syndrome. Comorbidity such as depression is quite a well-known issue in relation to the autism spectrum [3]. Indeed, not so long ago I was interested to read the paper by Gotham and colleagues [4] on how rumination - "compulsively focused attention on the symptoms of one's distress" - might play a role in depression in some cases of autism and where this could lead from a therapeutic standpoint. I'll also direct you to the paper by Ljung and colleagues [5] concluding that: "Attention-deficit/hyperactivity disorder [ADHD] is associated with an increased risk of both attempted and completed suicide" which might tie into the links being made between autism and ADHD (see here).Insofar as other conditions more generally linked to suicide such as psychosis [6] there is also perhaps something to do with the Cassidy results in mind, as a consequence of Asperger syndrome not being protective against the development of psychosis (see here). Social exclusion or alienation is also something reported with regards to the autism spectrum. I'm due to publish a mega-post quite soon on some of the research literature looking at quality of life (QoL) with autism in mind. Certainly in amongst that collected work, there are multiple examples of how loneliness and social isolation can be very detrimental factors to QoL.At this point I'm also minded to bring in the possibility that suicide ideation or planning might not be just solely due to psychological or societal factors but rather may be influenced by something like biology too. Regular readers of this blog probably already know about my fascination with all-things vitamin D. It's timely that I talked about some of the collected literature looking at vitamin D deficiency in relation to something like depression recently (see here). Even perhaps more timely that said deficiency of the sunshine vitamin/hormone might also be something to look at with [adult] autism in mind (see here). I'm not necessarily suggesting a cause-and-effect scenario linking these elements, merely that this could be something to look at in future. Perhaps also in the same light as looking at another interest of mine: gluten and "feelings of depression"? How about other trace minerals and suicide too?Whatever the reasons for thoughts of suicide to be linked to the autism spectrum, there is an important message to come from the Cassidy results and other papers on this topic: "inform appropriate service planning and support to reduce risk in this clinical group". Or I could just say make greater efforts to ensure that everyone knows how valuable their lives are, how valued they are as individuals and that there are people to talk... Read more »

Sarah Cassidy, Paul Bradley, Janine Robinson, Carrie Allison, Meghan McHugh, & Simon Baron-Cohen. (2014) Suicidal ideation and suicide plans or attempts in adults with Asperger's syndrome attending a specialist diagnostic clinic: a clinical cohort study. Lancet Psychiatry. info:/doi:10.1016/S0140-6736(08)61345-8

  • June 25, 2014
  • 01:00 PM

Anti-aging drug has a Catch… but not for Long

by Gabriel in Lunatic Laboratories

Dietary restriction holds the key to longevity. It’s no secret that as you drastically reduce calories, your metabolism will slow down with it [ask anyone who's tried to crash diet […]... Read more »

Yu Z, Wang R, Fok WC, Coles A, Salmon AB, & Pérez VI. (2014) Rapamycin and Dietary Restriction Induce Metabolically Distinctive Changes in Mouse Liver. The journals of gerontology. Series A, Biological sciences and medical sciences. PMID: 24755936  

  • June 25, 2014
  • 12:00 PM


by Robb Hollis in Antisense Science

Animal testing is an incredibly controversial subject, with strong opinions on both sides. Whilst animal testing for cosmetics has now been banned in the EU, animals continue to be used in science, where they serve a vital role in biomedical research and drug development. Their importance is often overshadowed by the ethical issues surrounding the treatment of animals in research environments, and it’s important that people understand why and how they are used, as well as what measures are taken to ensure that they are treated correctly and replaced where possible.
... Read more »

Hajar, R. (2011) Animal testing and medicine. Heart Views, 12(1), 42. DOI: 10.4103/1995-705X.81548  

  • June 25, 2014
  • 04:33 AM

Silence ENO2! More epigenetics and autism

by Paul Whiteley in Questioning Answers

The paper by Yu Wang and colleagues [1] (open-access here) concluded that: "reduced ENO2 expression may be a biomarker for a subset of autistic children" following their genome-wide methylation study of autism. For those who've picked up the word 'methylation' in that first sentence, this is yet another sign that epigenetics - the science of changes to gene function not entailing structural genomic changes - is starting to impact on autism research.Silentio! @ Wikipedia Based on an initial analysis of 5 pairs of participants - five diagnosed with autism, the other five being asymptomatic controls - drawn from a larger study population (n=131 pairs), researchers conducted a genome-wide study of venous blood samples for methylation variations in gene promoter regions and CpG islands using a method called MeDIP. Candidate genes (LASS3, PANX2, SLC15A4 and ENO2) which showed differential methylation patterns between the autism vs. control samples were selected for further investigation, after which ENO2 became the target gene for the study. It was then a case of verifying the methylation status of ENO2 (via BSP sequencing) in cases and controls of the larger participant groups followed by some analysis of the expression of ENO2 with regards to RNA levels and protein expression.The results: "hypermethylation of a single gene, ENO2, may be associated with about 15 % ofautistic cases". All of the children with ENO2 hypermethylation had "significant language development disorder" which contrasted with the other children in the autism group who "had more or less spoken language" although I didn't note any specific language measure to be used in this trial. ENO2 RNA levels were "reduced by about 70% relative to that in controls" and ENO2 protein expression in the hypermethylated group "was about half of that of controls".Ergo, "ENO2 expression may be a biomarker for a subset of autistic children".OK first things first, CpG sites and DNA. Imagine if you will, that in amongst the very complicated genetic blueprint which guides things like eye colour or whether you've inherited that magnificent nose from dad or mum, there are islands of DNA which contain a particular sequence separated by phosphate: cytosine - phosphate - guanine (CpG). The cytsosine part of the CpG site can be methylated - the addition of a methyl group - to form 5-methylcytosine; methylation in this respect generally taken to mean gene silencing or at least a reduction in gene function which can then lead to decreased gene transcription and onwards less protein expression.The Wang results basically plotted how from looking at the methylation status of the genome, a specific candidate gene showing something like a distinct methylation pattern in some cases of autism was followed through to see how said methylation affects gene function. It goes without saying that this was a very preliminary study and judging by the participant numbers needed in more traditional studies looking at structural changes to the genome (SNPs, CNVs et al) replication on a much grander scale (and looking at specific tissues) is absolutely implied before anyone gets too carried away. That also it's most probably autisms over autism together with the the principles of RDoC are other issues to be kept in mind.Still, I don't want to take anything away from the Wang results and what they 'could' potentially mean in light of other research in this area. Whether or not ENO2 survives future replicative studies is to some extent secondary to the question of why this gene was hypermethylated in the first place? Does this suggest a role for some of the DNA methyltransferases in relation to autism? What about the mechanisms of methyl donation and the functions of things like S-Adenosyl methionine (SAMe) in that process? Lots of different layers of complexity to be added to our knowledge of the genome.Music to close. Coldplay and Magic...----------[1] Wang Y. et al. Hypermethylation of the enolase gene (ENO2) in autism. Eur J Pediatr. 2014 Apr 17.----------Wang Y, Fang Y, Zhang F, Xu M, Zhang J, Yan J, Ju W, Brown WT, & Zhong N (2014). Hypermethylation of the enolase gene (ENO2) in autism. European journal of pediatrics PMID: 24737292... Read more »

Wang Y, Fang Y, Zhang F, Xu M, Zhang J, Yan J, Ju W, Brown WT, & Zhong N. (2014) Hypermethylation of the enolase gene (ENO2) in autism. European journal of pediatrics. PMID: 24737292  

  • June 24, 2014
  • 01:34 PM

Autism and Pesticides: What, too obvious?

by Gabriel in Lunatic Laboratories

There have been a few different things linked to children who fall under the Autism Spectrum Disorder. A combination of genetic and environmental factors, along with complications during pregnancy have been associated […]... Read more »

Shelton, J., Geraghty, E., Tancredi, D., Delwiche, L., Schmidt, R., Ritz, B., Hansen, R., & Hertz-Picciotto, I. (2014) Neurodevelopmental Disorders and Prenatal Residential Proximity to Agricultural Pesticides: The CHARGE Study. Environmental Health Perspectives. DOI: 10.1289/ehp.1307044  

  • June 24, 2014
  • 12:22 PM

E-cigarettes and Smoking Cessation

by William Yates, M.D. in Brain Posts

Electronic or e-cigarettes are a tobacco cigarette alternative that is growing in popularity.Proponents of e-cigarettes note the product contains no carbon monoxide, tar or other tobacco residue. The inhaled vapor in e-cigarettes is primarily nicotine.Additionally, some proponents of e-cigarettes declare the product is associated with reduction or cessation of tobacco-based cigarette use.Unfortunately, this is an area where public health trends come before scientific research data is collected. Few studies of the safety and effectiveness of e-cigarettes in smoking cessation have been published.One large study of electronic cigarettes and smoking cessation was completed and recently published in the journal Lancet.In this study, 657 smokers who wanted to quit were randomized one of three interventions: 16 mg nicotine e-cigarettes, 21 mg nicotine patches or placebo e-cigarette (nicotine free).  Abstinence from cigarettes was verified by low concentrations of carbon monoxide.At the end of the study the cigarette abstinence rates for the three groups were:E-cigarettes: 7.3%Nicotine patch: 5.8%Placebo e-cigarettes: 4.1%These low rates of abstinence across all interventions were surprising to the researchers conducting the study. The overall low rates of abstinence reduced the statistical power of the study and no statistical difference across the three groups could be proven.Some smokers adopting e-cigarettes do not desire or intent to quit. In this group, a separate research question is what is the natural history of cigarette smoking in high-risk populations who start to use e-cigarettes?One small study looking at this question has been published in a group of 14 smokers with schizophrenia.In this study, smoking subjects were allowed to use ad lib an e-cigarette product. Subjects kept a diary of the number of tobacco cigarettes smoked.The results of this study found 2 of the 14 subjects quit tobacco cigarettes over the year long course of the study. An additional seven subjects reduced the number of cigarettes smoked by  50% or more by the end of the study. No adverse effects on schizophrenia symptoms levels were noted by participation in this study.With such a limited research database, it is really too early to make a recommendation about e-cigarettes as a tool for smoking cessation.There are quite a few studies in the pipeline that should inform smokers and clinicians. A query using the search term e-cigarette at the website produced 27 research study listings. Readers can access this list here.Readers with more interest in the two studies summarized here can access the abstracts and free full-text (schizophrenia study only) in the citations below.Photo of skimmer birds at sunset on South Padre Island, TX is from the author's files.Follow the author on Twitter at:  WRY999Bullen, C., Howe, C., Laugesen, M., McRobbie, H., Parag, V., Williman, J., & Walker, N. (2013). Electronic cigarettes for smoking cessation: a randomised controlled trial The Lancet, 382 (9905), 1629-1637 DOI: 10.1016/S0140-6736(13)61842-5Caponnetto P, Auditore R, Russo C, Cappello GC, & Polosa R (2013). Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study. International journal of environmental research and public health, 10 (2), 446-61 PMID: 23358230... Read more »

Bullen, C., Howe, C., Laugesen, M., McRobbie, H., Parag, V., Williman, J., & Walker, N. (2013) Electronic cigarettes for smoking cessation: a randomised controlled trial. The Lancet, 382(9905), 1629-1637. DOI: 10.1016/S0140-6736(13)61842-5  

  • June 24, 2014
  • 10:45 AM

City Birds Are Adapted for Every Kind of Stress

by Elizabeth Preston in Inkfish

Whether you make your home in a high-rise apartment building or a drainpipe, city life has a different pace than country life. Urban environments mean an endless series of challenges for your mind and body: noise, crowds, pollution, quick decisions while facing oncoming vehicles. City-dwelling humans like to think of themselves as  tough and not […]The post City Birds Are Adapted for Every Kind of Stress appeared first on Inkfish.... Read more »

Costantini, D., Greives, T., Hau, M., & Partecke, J. (2014) Does urban life change blood oxidative status in birds?. Journal of Experimental Biology. DOI: 10.1242/​jeb.106450  

  • June 24, 2014
  • 09:05 AM

Social Networks May Guide Parents to Particular Autism Interventions

by amikulak in Daily Observations

After receiving a life-changing diagnosis for themselves or a loved one, people often turn to social networks for support and information. Parents of children diagnosed with autism spectrum disorder (ASD) […]... Read more »

  • June 23, 2014
  • 03:53 PM

Pesticides and autism: chapter II

by Paul Whiteley in Questioning Answers

I've labelled this entry a chapter II post reflecting some continued interest in how agricultural pesticide exposure might fit into autism research (see here for the chapter I post). In that previous post, I talked about various issues such as the old correlation-is-not-necessarily-causation mantra and indeed, how use of something like galantamine for cases of autism spectrum disorder (ASD) [1] might present something of a paradox for certain types of pesticides being involved in the condition, as a function of its similar acetylcholinesterase inhibitor activity (albeit reversible).Altogether Now? @ Wikipedia Continuing the pesticide theme, I'm talking today about the paper by Janie Shelton and colleagues [2] (open-access) and their results strengthening "the evidence linking neurodevelopmental disorders with gestational pesticide exposures, and particularly, organophosphates". Some of the press on this study be seen here.Based on data derived from the CHARGE study (beincharge!) authors reported that maternal residence during pregnancy close to locations undertaking "agricultural pesticide application" might elevate the risk of offspring autism; something previously discussed by some of the authors [3]. Results from CHARGE by the way, have already talked about other environmental associations with autism risk such as air pollution (see here). This initiative also recently confirmed what many people already knew in saying the gastrointestinal (GI) symptoms seem to be over-represented in cases of autism (see here).The Shelton paper is open-access but here are a few pointers:With an authorship list of the great and the good associated with CHARGE, commercial pesticide use data was linked to the addresses of mothers when pregnant for groups diagnosed with autism (n=486) or developmental delay (DD) (n=168) compared with asymptomatic controls (n=316) living in California, USA. As alluded to in a post on that most undesirable of jobs - the commercial pesticide applicator - commercial pesticide use tends to be quite tightly regulated as a result of the potential for health effects when mis-used.Various models and algorithms built up a statistical picture of different classes of pesticides, their use and when and where they sprayed. The authors aimed to ascertain whether gestational exposure was linked to autism risk and whether there were "specific windows of vulnerability during gestation". Results: bearing in mind there were quite a few estimates built into this study, a few points are worth mentioning. "Proximity to organophosphates at some time during gestation was associated with a 60% increased risk for ASD". Organophosphate (OP) pesticides were also "the most commonly applied agricultural pesticide near the home during pregnancy" and chlorpyrifos exposure in particular, during the 2nd trimester, seemed to show some association with offspring ASD risk."Children of mothers residing near pyrethroid insecticide applications, just prior to conception or during 3rd trimester were at greater risk for both ASD and DD". Pyrethroids were the "second most commonly applied class of pesticides".A few additional points: males were slightly more likely than females to be exposed to pesticides during gestation, and the effects of multiple exposures (various different classes of pesticides) was generally "not found to be higher that the observations of the individual classes of pesticides".Reiterating that this was a study based on estimation rather than looking at actual individual pesticide exposure during pregnancy or any biological testing for said exposure, this is an interesting study. I say that not to further condemn pesticides, which actually do quite a good job at helping to maintain our food supply and reduce our exposure to various pests. But rather that further study is indicated in this area as a result. The authors note the various strengths of their study based to a large extent on the fairly extensive data held on CHARGE participants. Likewise they note that their study did not for example, take into account "external non-agricultural sources" of pesticides such as those which many of us see sprayed around our homes, gardens and other areas of residence/work which could have affected their data. An 'underestimate' in actual exposure according to some external commentary on the study.The question of pesticide exposure being potentially linked to autism risk carries quite a bit of the same baggage as the air pollution correlation. Yes, to some degree, we're all pretty unfit for consumption (see here) as a function of our 'chemical load' - bearing in mind the mis-representation of that word. Some people use this generality as a stick to beat such hypotheses on environment being potentially linked to conditions like autism (yes, we know the autisms are a complicated set of conditions). But as we've seen with the air pollution work, it may be the sum of the environmental risks combined with some genetic fragility which eventually provides the more important answers (see here); something which Shelton et al conclude: "Further research on gene-by-environment interactions may reveal vulnerable sub-populations". I might at this point also throw in a related post on Reelin and OPs as one area where we might begin searching.In terms of the mechanism of effect, well if other autism research is anything to go by, it's gonna be complicated and probably not just confined to old the grey-pink matter. The obvious place to start looking would be the biological mechanisms which we rely on to metabolise things like OPs. PON1 is a good example, and as I've mentioned in other posts (see here) how PON1 has already seen some autism research action [4]. Indeed the paper by Gaita and colleagues [5] adds to the interest here and their findings of decreased serum arylesterase activity in case of autism. Paşca and colleagues [6] further suggested that a correlation (that word again) between hig... Read more »

Janie F. Shelton, Estella M. Geraghty, Daniel J. Tancredi,, Lora D. Delwiche, Rebecca J. Schmidt, Beate Ritz, Robin L. Hansen, & Irva Hertz-Picciotto. (2014) Neurodevelopmental disorders and prenatal residential proximity to agricultural pesticides: The CHARGE study. Environmental Health Perspectives. info:/10.1289/ehp.1307044

  • June 23, 2014
  • 02:59 PM

Methadone side effects – practising harm reduction on the harm reduction

by DJMac in Recovery Review

Methadone, evidenced in harm reduction outcomes, is not without its potential pitfalls. It looks like one of these is osteoporosis, or thinning of the bones. All men on methadone maintenance programmes should be having bone checkups. That was the conclusion of a past paper in the journal Addiction. Why? It looks like taking methadone long [...]
The post Methadone side effects – practising harm reduction on the harm reduction appeared first on Recovery Review.
... Read more »

Grey, A., Rix-Trott, K., Horne, A., Gamble, G., Bolland, M., & Reid, I. (2011) Decreased bone density in men on methadone maintenance therapy. Addiction, 106(2), 349-354. DOI: 10.1111/j.1360-0443.2010.03159.x  

  • June 23, 2014
  • 01:30 PM

The Iceman Cometh

by Gabriel in Lunatic Laboratories

Are you so fat you can’t see your toes? Have you forgotten what toes even look like? Have you been mistaken for the infamous “Kool-aid man”? Want to shed the […]... Read more »

Lee, P., Smith, S., Linderman, J., Courville, A., Brychta, R., Dieckmann, W., Werner, C., Chen, K., & Celi, F. (2014) Temperature-acclimated brown adipose tissue modulates insulin sensitivity in humans. Diabetes. DOI: 10.2337/db14-0513  

Liu, M., Bai, J., He, S., Villarreal, R., Hu, D., Zhang, C., Yang, X., Liang, H., Slaga, T., Yu, Y.... (2014) Grb10 Promotes Lipolysis and Thermogenesis by Phosphorylation-Dependent Feedback Inhibition of mTORC1. Cell Metabolism, 19(6), 967-980. DOI: 10.1016/j.cmet.2014.03.018  

  • June 23, 2014
  • 10:52 AM

Varenicline for Smoking Cessation

by William Yates, M.D. in Brain Posts

Varenicline is a drug designed to assist smokers in cessation. It is marketed in the U.S. as Chantix.Varenicline is one of the first drugs to target the nicotine receptor. It is classified as a partial agonist, meaning it stimulates the nicotine receptor but to a weaker effect than nicotine itself.The mechanism of action of varenicline differs from that of another smoking cessation drug bupropion marked under trade name Zyban in the U.S.One concern with varenicline is the risk for psychiatric adverse effects including increase in anxiety ratings, increase in depression ratings and increased suicidality.There have been several studies over the last year that have expanded the knowledge base on varenicline. Here are four that I found from a search of PubMed.Clinical trial finds combining varenicline with bupropion improves quit ratesA randomized clinical trial of 506 subjects with nicotine dependence was completed across several setting in the U.S.  At 12 weeks 53% of subjects in the combined varenicline/buproprion were smoking abstinent compared to 43% of those in the varenicline alone group.The was a slight increase in reported anxiety (7.2% vs 3.1%) and depression (3.6% vs 0.8%) in the combined therapy groups.Combined varenicline/bupropion helpful in those failing nicotine patch treatmentA group of 222 smokers who failed to respond to a nicotine patch trial were randomized to varenicline plus bupropion versus varenicline alone. Abstinence rates at 12 weeks were 39.8% for the combined drug group compared to 25.9% for the varenicline plus placebo group. This was a statistically significant advantage. Combined therapy appeared more helpful for male smokers and smokers with higher levels of nicotine dependence.Varenicline effective and safe in a sample of subjects with major depressionThe safety and effectiveness of varenicline in the original trials typically was studied in individuals without a psychiatric history of depression or suicidal ideation. Anthenelli and colleagues recruited a series of smokers with current major depression or a history of major depression for a varenicline study. Varenicline 1 mg twice daily was compared to placebo in a 12 week randomized controlled trial.Subjects with recent major depression had to be on a stable antidepressant treatment regimen for 2 months prior to enrollment.Varenicline treated subjects had higher abstinence rates at 9 to 12 weeks (35.9% vs 15.6%). Importantly, the varencline treated group at risk for depression showed no increase in suicidal ideation, anxiety or depression during active treatment.Belgium study finds predictors for success with vareniclineBoudrez and colleagues examined a cohort of varenicline treated subjects. The time to first cigarette on awakening was found to be related to smoking cessation rates. At week 12, the odds ratio for time to first cigarette and abstinence was 0.69 (95% confidence interval 0.50 to 0.94). This suggests varenicline as more effective in those with shorter duration to first cigarette an indicator of nicotine dependence.This study also found use of behavioural support predicted higher quit rates in smokers.CommentaryThese four studies lend support to the effectiveness and safety of varenicline in smoking cessation drug therapy. Combining varenicline with the antidepressant bupropion may boost quit success rates.These results also support use of varenicline as a treatment option for those with a history or current depression. This group appears to have somewhat lower rates of success compared to non-depressed sample groups.Clinical trials for those with nicotine dependence and a psychiatric diagnosis are important. Several psychiatric disorders have increased rates of smoking and nicotine dependence. It is probably best to consider smoking cessation drug treatment during periods of remission and stability of the primary psychiatric diagnosisReaders with more interest in this topic can access the abstracts by clicking on the links below. The Anthenelli et al citation has a link to a free full text manuscript.Disclosure: The author has no financial association with any pharmaceutical company including the maker of varenicline in the U.S. This post topic was selected and completed by the author alone with no payment.Follow the author on Twitter at WRY999Photo of American bittern in South Padre Island, TX is from the author's files.Ebbert JO, Hatsukami DK, Croghan IT, Schroeder DR, Allen SS, Hays JT, & Hurt RD (2014). Combination varenicline and bupropion SR for tobacco-dependence treatment in cigarette smokers: a randomized trial. JAMA : the journal of the American Medical Association, 311 (2), 155-63 PMID: 24399554Rose JE, & Behm FM (2014). Combination Treatment With Varenicline and Bupropion in an Adaptive Smoking Cessation Paradigm. The American journal of psychiatry PMID: 24934962Anthenelli RM, Morris C, Ramey TS, Dubrava SJ, Tsilkos K, Russ C, & Yunis C (2013). Effects of varenicline on smoking cessation in adults with stably treated current or past major depression: a randomized trial. Annals of internal medicine, 159 (6), 390-400 PMID: 24042367... Read more »

  • June 23, 2014
  • 10:30 AM

The Iceman Cometh

by Gabriel in Lunatic Laboratories

Are you so fat you can't see your toes? Have you forgotten what toes even look like? Have you been mistaken for the infamous "Kool-aid man"? Want to shed the pounds easier than taking off your shirt? Well too bad, that is science fiction and the stuff of horrid marketing ploys and this my friends is a science website. Losing weight is hard, I've written several articles on it in fact. Nothing is going to be more effective at weight loss than a sensible diet, a calorie deficit and maybe some insoluble fiber that I mentioned in the very first article I've written.... Read more »

Lee, P., Smith, S., Linderman, J., Courville, A., Brychta, R., Dieckmann, W., Werner, C., Chen, K., & Celi, F. (2014) Temperature-acclimated brown adipose tissue modulates insulin sensitivity in humans. Diabetes. DOI: 10.2337/db14-0513  

Liu, M., Bai, J., He, S., Villarreal, R., Hu, D., Zhang, C., Yang, X., Liang, H., Slaga, T., Yu, Y.... (2014) Grb10 Promotes Lipolysis and Thermogenesis by Phosphorylation-Dependent Feedback Inhibition of mTORC1. Cell Metabolism, 19(6), 967-980. DOI: 10.1016/j.cmet.2014.03.018  

  • June 23, 2014
  • 08:26 AM

Pushing the Living Kidney Donor Agenda

by Cristy at Living Donor 101 in Living Donors Are People Too

It’s no secret that the overwhelming majority of medical practitioners specializing in chronic kidney disease prefer living kidney donor transplants as a treatment for their patients. But this is the second time in recent history I’ve run across a study that actively propagandizes to would-recipients *and their social network* about the practice. It’s not particularly …
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The post Pushing the Living Kidney Donor Agenda appeared first on Living Donors Are People Too.
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Ismail SY, Luchtenburg AE, Timman R, Zuidema WC, Boonstra C, Weimar W, Busschbach JJ, & Massey EK. (2014) Home-Based Family Intervention Increases Knowledge, Communication and Living Donation Rates: A Randomized Controlled Trial. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. PMID: 24935081  

  • June 23, 2014
  • 06:17 AM

Why Measles, Whooping Cough (And Autism) Are Expanding

by Rebekah Morrow in United Academics

Preventable diseases such as whooping cough and measles are more prevalent now than they have been in many years. Most of these outbreaks occur in places where vaccination levels are low. What does this mean for the global population, both vaccinated and unvaccinated?... Read more »

John TJ, & Samuel R. (2000) Herd immunity and herd effect: new insights and definitions. European journal of epidemiology, 16(7), 601-6. PMID: 11078115  

  • June 23, 2014
  • 04:30 AM

Kata training and autism

by Paul Whiteley in Questioning Answers

The actor and musician Steven Seagal is probably not natural fodder for this blog about autism research but he does nevertheless make an appearance today. More readily known for his action films - my favourite was always 'Under Siege' - one of the appeals of Mr Seagal was his knowledge and use of martial arts in his various roles, as a function of his quite impressive real-life black belt in Aikido.Obi Wan... no Obi knot @ Wikipedia It is with martial arts in mind that today I'm talking about an interesting paper by Ahmadreza Movahedi and colleagues [1] and some observations on the use of kata techniques on social interactive abilities in a small group of children diagnosed with an autism spectrum disorder (ASD). Kata by the way, refer to the various structured patterns of movements practised as part of martial arts like karate. Normally incorporating various blocks and offensive (attacking) movements, kata are an integral part of martial arts training and vary in their complexity and number of moves (see here). Practice makes perfect is the primary tenet of kata training.A few details about the Movahedi paper might be useful:Thirty children diagnosed with ASD formed the participant group. None had any experience or training in kata techniques. They were randomly assigned to an exercise group (n=15) or a control group (n=15). Heian Shodan (see this video for what this encompasses) kata was the chosen "experimental task" (one of the first kata taught in Shotokan karate). Training was delivered to the exercise group as part of a structured schedule; all sessions were videotaped to "control the trainers' teaching method as precisely as possible".Exercise group participants received kata instruction "1 session/day. 4 days/week for 14 weeks (56 sessions)". Sessions involved initially watching a video of someone performing the kata and then receiving personal instruction from trainers onwards to performing the kata. Warm-up and cool-down exercise started and finished each session whilst "Persian music" was playing (this study was completed in Iran).Social interaction was measured at baseline before intervention and post-intervention at 14 weeks based on the use of the Gilliam Autism Rating Scale (GARS-2). Observations were carried out by "caregivers, parents and teachers" and based on the "frequency of occurrence of each social behaviour under ordinary circumstances in a 6-h period".Results: there was no significant differences on the social interaction subscale of the GARS at baseline (before intervention) between the groups. After intervention however "the participants of the exercise group demonstrated a substantial improvement in social interaction" compared to the control participants. This improvement also seemed to last even after 30 days of no training at the conclusion of the kata training for the exercise group. The authors concluded that kata training is an effective avenue for improving social interaction for children with ASD. Perhaps wider that their results may help providers to "decide to establish strategic plans under which martial arts techniques will best be instructed to children with ASD".Bearing in mind the small numbers of participants included in this study, I was impressed by these findings. I'm quite a fan of the martial arts and some of the philosophy behind them and how they might relate to various facets of autism, be it stress (see here and see here), self-confidence (see here) or just getting someone more active (see here). Most people who take part in and/or watch loved ones take part in activities such as karate, whether diagnosed with autism or not, see very quickly how such training offers a multitude of benefits outside of just increased physical activity (and onwards academic performance?). Self-confidence and self-regulation (difficult concepts to measure) tend to be some of the primary psychological benefits of the martial arts. Whether this comes from the actual training or as a result of the knowledge that the training brings is still a question open to some debate. Anger and aggression can also be 'channelled' as a function of certain martial arts training [2]. Given the principles on which something like karate is based, this is perhaps not all that surprising. The social interactive aspect included in martial arts reflects interaction with both Sensei (teacher) and other students, who, in a real-life setting, will generally include various ages and various different grades (see here) and hence incorporates a spirit of partner practising and helping out those less experienced. All these elements can positively combine together to promote a sense of belonging.Other research has also looked at the effects of kata training on other aspects of autism. The paper by Bahrami and colleagues [3] (yes, the same authorship group) talked (I think) about the same participant group also showing "significantly reduced stereotypy" following training. Again, the benefits were seen even after the training period had been completed. A further case study paper by the same authors showed similar things [4].The paper by Torres [5] using martial arts training as a means to assess movement in relation to autism hints at another interesting area of potential study. It's long been discussed in autism research circles that movement and gait seem to be 'affected' in quite a few instances of autism [6]. I've covered some of the peripheral issues on this blog including toe walking (see here) and that curious issue of joint hypermobility (see here) talked about further in a paper by Shetreat-Klein and colleagues [7]. The intriguing question is whether the often very intricate and certainly 'balance-orientated' movements included in kata training might likewise have some positive effects on autism. Indeed if, as is starting to be discussed, motor skills do show a connection with autism characteristics [8], whether the effects of kata training on motor skills may be a route to affecting other core issues associated with autism?So, music to close. I'll forgo the obvious music with a martial arts slant (no, not Kung-Fu fighting) and instead go for some Arctic Monkeys.... I bet that you look good on the dance floor (well, do yer?)----------[1] Movahedi A. et al. Improvement in social dysfunction of children with autism spectrum disorder following long term Kata techniques training. Resear... Read more »

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