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  • May 25, 2015
  • 09:59 PM
  • 144 views

How houseflies resist the toxic effects of DDT

by Rosin Cerate in Rosin Cerate

Alright, it's insecticide day here at Rosin Cerate, and I've decided to look back at a classic.DDT is a synthetic organochloride insecticide, meaning that we have to manufacture it by reacting chemicals together, it consists of hydrogen, carbon, and chlorine atoms, and it's good at killing many annoying invertebrates including flies, lice, and mosquitoes.While it's useful in that it can kill insects, three key properties of DDT enable it to cause serious ecological problems: (1) it's often not easily broken down in the environment, (2) it's bad at dissolving in water but will readily dissolve in fat, and (3) it's toxic effects aren't limited to insects. Taken together, you have a compound that tends to stick around and can accumulate to damaging levels in the body fat of various organisms. As you move up the food chain (e.g. plants eaten by insects eaten by songbirds eaten by birds of prey) you get higher DDT concentrations, with top predators such as peregrine falcons consuming the highest amounts of the insecticide and thus being most severely affected.The egg on the right was laid by a bird exposed to DDT (Source)Although DDT was first synthesized in the late 19th century, its ability to kill insects wasn't recognized until 1939 (and won this dude a Nobel Prize). This was good timing since DDT was subsequently employed during Word War II to reduce insect-spread diseases including malaria and typhus. After the war, the insecticide was quickly adopted by farmers, becoming ubiquitous in agriculture until enough folks realized it was hurting wildlife. This eventually led it to being banned mostly everywhere in the world, although it still remains in use for malaria control in some countries.As is the case with substances designed to kill bacteria, fungi, and cancer cells, DDT has become less useful against insects over time as individuals able to resist its toxic effects appear and multiply within a population. In particular, resistance has been observed in houseflies (Musca domestica), which are impacted wherever buildings are sprayed with DDT to control malaria-bearing mosquitoes. In many cases it eventually becomes necessary to switch insecticides in order to control fly populations.This is a housefly (Musca domestica). Gross. (Source)Although DDT isn't particularly relevant anymore, I think it's still interesting to look at how it's resisted by houseflies, as this demonstrates how different tweaks of an organism's genetic makeup can result in the same beneficial characteristic, i.e. being better at not being killed by DDT. By comparing populations of houseflies that are generally able to withstand a high dose of DDT (resistant) with those that are generally killed by the same dose (sensitive), researchers have uncovered four characteristics that appear to confer DDT resistance.Firstly, some resistant flies have a different morphology than sensitive flies. When its use was widespread, DDT was often sprayed on surfaces such as walls, so flies were exposed to the insecticide when they landed on or wandered across the surface. This exposure occurred via their feet coming into direct contact with the insecticide with subsequently being absorbed into their bodies via their legs. Some resistant flies have narrower feet and altered leg structure (i.e. thicker intersegmental membranes) compared to sensitive flies, characteristics that likely reduce their DDT exposure.Secondly, some resistant flies have a higher proportion of body fat compared to sensitive flies. These fats are also relatively more unsaturated and contain more iodine, which means they can dissolve a tonne (well, probably not quite) of DDT. Further, the lipid and cholesterol content of nervous tissue, the main target of DDT, differs between resistant and sensitive populations. It has been proposed that these characteristics enabled flies to partition DDT within their bodies such that it was kept away from their nervous system, providing a protective effect.Thirdly, some resistant flies produce a bunch of DDT-dehydrochlorinase, an enzyme that destroys DDT by breaking off one of its chlorine atoms to form substantially less toxic DDE. Reflecting the action of the enzyme, large amounts of DDE have been found in resistant flies.Finally, some resistant flies have a slightly modified version of a voltage-sensitive sodium channel that is present throughout the nervous system of all animals. DDT kills flies by preventing the channel from working correctly, disrupting the electrical signals necessary for the nervous system to function. The modified channel possessed by resistant flies has a lower affinity for DDT, lessening the ability of the insecticide to kill.ReferencesKalow W. 1962. Pharmacogenetics: Heredity and the response to drugs. W.B. Saunders Company.Knipple DC, Doyle KE, Marsella-Herrick PA, Soderlund DM. 1994. Tight genetic linkage between the kdr insecticide resistance trait and a voltage-sensitive sodium channel gene in the house fly. Proceedings of the National Academy of Sciences of the United States of America 91(7):2483-2487. [Full text]Lipke H, Kearns CW. 1959. DDT dehydrochlorinase I. Isolation, chemical properties, and spectrophotometric assay. Journal of Biological Chemistry 234(8):2123-2128. [Full text]Mer GG. 1953. Daytime distribution of DDT-resistant houseflies inside DDT-sprayed buildings. Bulletin of the World Health Organization 8(4):521-526. [Full text]Soderlund DM, Knipple DC. 2003. The molecular biology of knockdown resistance to pyrethroid insecticides. Insect Biochemistry and Molecular Biology 33(6):563-577.... Read more »

  • May 25, 2015
  • 08:08 PM
  • 67 views

Family History Alone Does Not Affect Breast Cancer Recurrence

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Professor Ramsey Cutress Associate Professor in Breast Surgery University of Southampton Medical Research: What is the background for this study? What are the main findings? Response: The main finding is that in young women with breast cancer, … Continue reading →
The post Family History Alone Does Not Affect Breast Cancer Recurrence appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with:, & Professor Ramsey Cutress. (2015) Family History Alone Does Not Affect Breast Cancer Recurrence. MedicalResearch.com. info:/

  • May 25, 2015
  • 02:42 AM
  • 161 views

Ginkgo biloba for ADHD?

by Paul Whiteley in Questioning Answers

I approach the paper by Fereshteh Shakibaei and colleagues [1] with some degree of caution save any suggestions that I am somehow 'promoting' the herb Ginkgo biloba for attention-deficit hyperactivity disorder (ADHD) or anything else. I'm not, but I am interested in the results of their placebo-controlled trial suggesting that "The G. biloba is an effective complementary treatment for ADHD" and their subsequent calls for further research into this potentially promising intervention.As per the Medline Plus entry for Ginko biloba, irrespective of your views on herbal remedies and health (have you never heard of pharmacognosy?), there is a growing evidence base suggesting that such a preparation might have a place in the management of quite a few conditions/diagnoses. The caveat being that (a) quite a bit more research is needed, and (b) much like more mainstream pharmaceutics, such herbs are not without their contraindications when it comes to their use alongside other medicines. Treat your herbs et al like you would your typical medicines is the best advice, bearing in mind I don't give medical or clinical advice on this blog.Shakibaei et al reported results looking at a group of children/adolescents over 6 weeks already in receipt of pharmacotherapy for their ADHD symptoms - "methylphenidate (20-30 mg/day" - to which either G. biloba was added - "80-120 mg/day" - or a placebo. They report that based on responses to the "Parent and teacher forms of the ADHD Rating Scale-IV (ADHD-RS-IV)" (something I've come across in my own research) compared with the placebo group "more reduction was observed with G. biloba" illustrative of potential positive changes to symptoms. The specific area of 'inattention' seemed to be positively affected by the use of G. biloba. The commonplace 'further studies are required' sentence completes the Shakibaei results.This is not the first times that G. biloba has been discussed in the peer-reviewed domain with ADHD in mind (see here). As per the 2009 review from Rucklidge and colleagues [2] (someone who knows a thing or two about supplements and ADHD) the jury is still out about G. biloba and it's possible effect with ADHD mind. Certainly, there are quite a few other candidate 'nutrient supplements' which seem to be performing quite a bit better than this herb (see here and see here for example).That being said, I'd be interested to see what future research has to say about the usefulness of G. biloba with ADHD in mind, specifically from the angle of an adjuvant (add-on) treatment alongside more traditional pharmacotherapy. Again, I say this without in any way, shape or form 'promoting' such use at the current time and with the understanding that management of ADHD is likely to require quite a holistic approach.Music: The Foo Fighters (who should be at the SoL anytime.... now).----------[1] Shakibaei F. et al. Ginkgo biloba in the treatment of attention-deficit/hyperactivity disorder in children and adolescents. A randomized, placebo-controlled, trial. Complement Ther Clin Pract. 2015 Apr 18. pii: S1744-3881(15)00029-8.[2] Rucklidge JJ. et al. Nutrient supplementation approaches in the treatment of ADHD. Expert Rev Neurother. 2009 Apr;9(4):461-76.----------Shakibaei F, Radmanesh M, Salari E, & Mahaki B (2015). Ginkgo biloba in the treatment of attention-deficit/hyperactivity disorder in children and adolescents. A randomized, placebo-controlled, trial. Complementary therapies in clinical practice PMID: 25925875... Read more »

  • May 24, 2015
  • 06:48 AM
  • 52 views

Number Of Infections Can Impact Cognitive Ability

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Dr. Michael Eriksen Benrós Mental Health Centre Copenhagen University of Copenhagen Faculty of Health Sciences Copenhagen NV, Denmark, National Centre for Register-based Research Aarhus University Denmark Medical Research: What is the background for this study? Response: It … Continue reading →
The post Number Of Infections Can Impact Cognitive Ability appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with: Dr. Michael Eriksen Benrós. (2015) Number Of Infections Can Impact Cognitive Ability. MedicalResearch.com. info:/

  • May 24, 2015
  • 06:41 AM
  • 49 views

Elderly Hypertensive Patient With Declining Kidney Function Risk Cardiovascular Events

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Enayet Karim Chowdhury, Research Fellow Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University The Alfred Centre Melbourne VIC 3004 Medical Research: What is the background for this study? What are the … Continue reading →
The post Elderly Hypertensive Patient With Declining Kidney Function Risk Cardiovascular Events appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with: Enayet Karim Chowdhury, Research Fellow. (2015) Elderly Hypertensive Patient With Declining Kidney Function Risk Cardiovascular Events. MedicalResearch.com. info:/

  • May 23, 2015
  • 03:59 PM
  • 137 views

Omega-3 as an intervention for childhood behavioral problems

by Dr. Jekyll in Lunatic Laboratories

We don’t usually think of a child’s behavior as a diet issue, but if new findings hold true, then that might be the very case. In a new study, researchers suggest that omega-3, a fatty acid commonly found in fish oil, may have long-term neurodevelopmental effects that ultimately reduce antisocial and aggressive behavior problems in children.... Read more »

  • May 23, 2015
  • 08:04 AM
  • 43 views

Minimal Differences Between Young Adults Raised by Gay/Lesbian or Heterosexual Parents

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Dr. Simon Cheng PhD. Department of Sociology University of Connecticut, Storrs, CT Medical Research: What is the background for this study? What are the main findings? Dr. Cheng: Our research is an empirical response to the Regnerus … Continue reading →
The post Minimal Differences Between Young Adults Raised by Gay/Lesbian or Heterosexual Parents appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with: Dr. Simon Cheng PhD. (2015) Minimal Differences Between Young Adults Raised by Gay/Lesbian or Heterosexual Parents. MedicalResearch.com. info:/

  • May 23, 2015
  • 07:54 AM
  • 47 views

Early Life Exposure To Antibiotics May Impact Adult Health

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Ms. Pajau Vangay Graduate Research Fellow Biomedical Informatics and Computational Biology Vice President of Grants, Council of Graduate Students University of Minnesota Medical Research: What is the background for this study? What are the main findings? Response: … Continue reading →
The post Early Life Exposure To Antibiotics May Impact Adult Health appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with: Ms. Pajau Vangay. (2015) Early Life Exposure To Antibiotics May Impact Adult Health. MedicalResearch.com. info:/

  • May 23, 2015
  • 07:43 AM
  • 46 views

Proximity To Liquor Stores Linked To Gun Violence, Especially In Distressed Neighborhoods

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Marie Crandall, MD, MPH, FACS Associate Professor of Surgery Northwestern University Feinberg School of Medicine Chicago, IL 60611   Medical Research: What is the background for this study? What are the main findings? Dr. Crandall: While the … Continue reading →
The post Proximity To Liquor Stores Linked To Gun Violence, Especially In Distressed Neighborhoods appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with: Marie Crandall, MD, MPH, FACS. (2015) Proximity To Liquor Stores Linked To Gun Violence, Especially In Distressed Neighborhoods. MedicalResearch.com. info:/

  • May 23, 2015
  • 03:53 AM
  • 196 views

Psychological morbidity of coeliac disease

by Paul Whiteley in Questioning Answers

"Anxiety, depression and fatigue are common complaints in patients with untreated celiac disease and contribute to lower quality of life."That was one of the conclusions reached in the paper by Fabiana Zingone and colleagues [1] (open-access available here) following their review of the research literature "on psychological morbidity of celiac disease." Celiac (coeliac) disease (CD), by the way, is the autoimmune condition classically treated via the use of a gluten-free diet (GFD). Readers might wish to peruse my training post on the condition for some further background information about some of the known 'hows and whys' (see here) as well as other posts on what we don't know about CD (see here) (hint: quite a bit).The Zingone paper is open-access so it doesn't require any grand discussions from me at this point. "Our search of the available literature suggests that CD has a considerable psychological impact" is another way the authors discuss their findings and I for one, would not argue with such sentiments on potential extraintestinal manifestations of the condition. Importantly, they make a distinction between whether such 'psychological impact' may directly derive from having the disease itself or other reasons potentially relating "to the patient’s subjective perception of the disorder and of the GFD used to treat it."I was also taken by some of the 'clinical implications' listed by the authors when it comes to the 'considerable psychological impact' including that: (1) "GFD improves quality of life (QoL) in symptomatic patients, but not always in asymptomatic patients", (2) "Anxiety and depression may affect dietary adherence and QoL" and (3) "Fatigue is sometimes the unique symptom at CD presentation."Point (1) taps into the idea of a better cost-benefit profile from the use of a GFD when people actually see such a diet improving their health and wellbeing. As per other rumblings on this blog, I might also suggest that this effect extends into some of the asymptomatic group too (see here). Point (2) raises an important issue that potential psychological effects associated with CD might have important implications for things like sticking to the diet. I wonder if that also includes those slightly outside of the classical presentation of CD too? Point (3) on fatigue as a possible 'unique' symptom of CD takes me back to a distant post titled 'gluten relations' and the idea that screening for CD or even the broader non-coeliac gluten sensitivity (NCGS) might be indicated in a few 'fatigue-linked' conditions including cases of chronic fatigue syndrome / myalgic encephalomyelitis (CFS / ME) (sorry, SEID). By saying that I'm not making any value judgements about SEID simply being CD or vice-versa, merely that within the spectrum of fatigue-manifesting conditions, one might find one or two surprising results [2] as you might in other conditions too [3].Yet after all that, mass screening for CD is still not indicated? [4]Music: Muse - Plug In Baby.----------[1] Zingone F. et al. Psychological morbidity of celiac disease: A review of the literature. United European Gastroenterol J. 2015 Apr;3(2):136-45.[2] Isasi C. et al. Fibromyalgia and chronic fatigue syndrome caused by non-celiac gluten sensitivity. Reumatol Clin. 2015 Jan-Feb;11(1):56-7.[3] Gadoth A. et al. Transglutaminase 6 Antibodies in the Serum of Patients With Amyotrophic Lateral Sclerosis. JAMA Neurol. 2015. April 13.[4] Ludvigsson JF. et al. Screening for celiac disease in the general population and in high-risk groups. United European Gastroenterol J. 2015 Apr;3(2):106-20.----------Zingone F, Swift GL, Card TR, Sanders DS, Ludvigsson JF, & Bai JC (2015). Psychological morbidity of celiac disease: A review of the literature. United European gastroenterology journal, 3 (2), 136-45 PMID: 25922673... Read more »

Zingone F, Swift GL, Card TR, Sanders DS, Ludvigsson JF, & Bai JC. (2015) Psychological morbidity of celiac disease: A review of the literature. United European gastroenterology journal, 3(2), 136-45. PMID: 25922673  

  • May 22, 2015
  • 03:11 PM
  • 168 views

Air pollution is causing your baby problems, but breastfeeding can help

by Dr. Jekyll in Lunatic Laboratories

Aitana Lertxundi has conducted her research work within the framework of the INma (Childhood and Environment) programme led by Jesús Ibarluzea of the Department of Health of the Government of the Basque Autonomous Community (region). The aim is to assess how exposure to environmental pollution during pregnancy affects health and also to examine the role of diet in physical and neurobehavioural development in infancy. The study focusses on the repercussions on motor and mental development during the first years of life caused by exposure to the PM2.5 and NO2 atmospheric pollutants.... Read more »

  • May 22, 2015
  • 03:02 PM
  • 172 views

Are infections making you stupid?

by Dr. Jekyll in Lunatic Laboratories

New research shows that infections can impair your cognitive ability measured on an IQ scale. The study is the largest of its kind to date, and it shows a clear correlation between infection levels and impaired cognition. Anyone can suffer from an infection, for example in their stomach, urinary tract or skin. However, a new Danish study shows that a patient’s distress does not necessarily end once the infection has been treated.... Read more »

  • May 22, 2015
  • 01:22 PM
  • 48 views

Obesity Leads To Reversible Changes In Diabetes-Predisposition Genes

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com interview Dorota Kaminska, MSc Department of Clinical Nutrition University of Eastern Finland MedicalResearch: What is the background for this study? What are the main findings? Response: The prevalence of obesity is increasing worldwide, making it one of the biggest … Continue reading →
The post Obesity Leads To Reversible Changes In Diabetes-Predisposition Genes appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com interview, & Dorota Kaminska, MSc. (2015) Obesity Leads To Reversible Changes In Diabetes-Predisposition Genes. MedicalResearch.com. info:/

  • May 22, 2015
  • 12:29 PM
  • 36 views

Chemotherapy Before Ovarian Cancer Surgery May Benefit Some Patients

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Mr Matthew Nankivell MRC Clinical Trials Unit at University College London Institute of Clinical Trials and Methodology Aviation House, London UK Medical Research: What is the background for this study? What are the main findings? Response: Ovarian … Continue reading →
The post Chemotherapy Before Ovarian Cancer Surgery May Benefit Some Patients appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with:, & Mr Matthew Nankivel. (2015) Chemotherapy Before Ovarian Cancer Surgery May Benefit Some Patients. MedicalResearch.com. info:/

  • May 22, 2015
  • 11:52 AM
  • 36 views

All-Cause Mortality Decreased In Post-Menopausal Women Who Reduce Sedentary Time

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Jasmine Lee, M.Sc. and Chris I. Ardern, Ph.D. School of Kinesiology and Health Science York University Toronto, ON, Canada Medical Research: What is the background for this study? Response: Although the benefits of physical activity are well … Continue reading →
The post All-Cause Mortality Decreased In Post-Menopausal Women Who Reduce Sedentary Time appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with: Jasmine Lee, M.Sc. and Chris I. Ardern, Ph.D. (2015) All-Cause Mortality Decreased In Post-Menopausal Women Who Reduce Sedentary Time. MedicalResearch.com. info:/

  • May 22, 2015
  • 10:41 AM
  • 27 views

Breastfeeding Rates Remain Low Among Minority Women

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Katherine Jones, M.A. Research Associate, Department of Research The American College of Obstetricians and Gynecologists Department of Psychology, American University Medical Research: What is the background for this study? What are the main findings? Response:  It is … Continue reading →
The post Breastfeeding Rates Remain Low Among Minority Women appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with: Katherine Jones, M.A., Research Associate Research Department, The American College of Obstetricians and Gynecologists, & Washington, DC 20024. (2015) Breastfeeding Rates Remain Low Among Minority Women. MedicalResearch.com. info:/

  • May 22, 2015
  • 07:18 AM
  • 37 views

Circulating Colon Cancer DNA Mutations May Predict Metastases

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Dr. Jeanne Tie Medical Oncologist | Royal Melbourne and Western Hospital Research Fellow Walter and Eliza Hall Institute of Medical Research Parkville, VIC Medical Research: What is the background for this study? Dr. Tie: The increasing number … Continue reading →
The post Circulating Colon Cancer DNA Mutations May Predict Metastases appeared first on MedicalResearch.com Medical Research Interviews and News.
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MedicalResearch.com Interview with: Dr. Jeanne Tie, Medical Oncologist | Royal Melbourne and Western Hospital, Research Fellow, Walter and Eliza Hall Institute of Medical Research, & Parkville, VIC. (2015) Circulating Colon Cancer DNA Mutations May Predict Metastases. MedicalResearch.com. info:/

  • May 22, 2015
  • 06:41 AM
  • 29 views

Black Young Gay Men From Poor Neighborhoods More Likely To Contract HIV

by Marie Benz in MedicalResearch.com

MedicalResearch.com Medical Research Interviews and News
MedicalResearch.com Interview with: Perry N Halkitis, Ph.D., M.S., MPH Professor of Applied Psychology Global Public Health, and Population Health/Medicine New York University. Medical Research: What is the background for this study? Dr. Halkitis: The P18 Cohort Study is a prospective … Continue reading →
The post Black Young Gay Men From Poor Neighborhoods More Likely To Contract HIV appeared first on MedicalResearch.com Medical Research Interviews and News.
... Read more »

MedicalResearch.com Interview with:, Perry N Halkitis, Ph.D., M.S., MPH, Professor of Applied Psychology, Global Public Health, and Population Health/Medicine, & New York University. (2015) Black Young Gay Men From Poor Neighborhoods More Likely To Contract HIV. MedicalResearch.com. info:/

  • May 22, 2015
  • 04:07 AM
  • 162 views

Clinical trials for rare diseases – finding and keeping patients

by Danielle Stevenson in BHD Research Blog

International Clinical Trial day (May 20th) celebrates the medical advances as a result of clinical trials. Clinical trials are essential to ensure drug safety and efficacy, and the recent increase in the development of orphan drugs has led to an increase in rare disease clinical trials. The nature of rare diseases creates specific challenges for clinical trial design and patient recruitment.... Read more »

  • May 22, 2015
  • 02:24 AM
  • 196 views

Early Start Denver Model (ESDM) and autism: 2 year outcomes

by Paul Whiteley in Questioning Answers

"These results provide evidence that gains from early intensive intervention are maintained 2 years later. Notably, core autism symptoms improved in the ESDM [Early Start Denver Model] group over the follow-up period relative to the COM [community-intervention-as-usual] group."Those were some of the conclusions reported in amongst the potentially very important results from Annette Estes and colleagues [1] looking at "the sustained effects of early intervention" following previous studies [2] specifically looking at the ESDM for children with an autism spectrum disorder (ASD). ESDM by the way, is a behavioural intervention model that draws on elements of Applied Behaviour Analysis (ABA) and is based on 'a relationship-focused developmental model'.Authors reported that when examining follow-up data for some 39 children aged 6 previously included in a trial of ESDM, those that received intervention (compared to those in receipt of 'treatment as usual') "demonstrated improved core autism symptoms and adaptive behavior." These findings were present despite no significant group differences in intellectual functioning between ESDM and COM participants. Perhaps also important were the discussions that: "The two groups received equivalent intervention hours during the original study, but the ESDM group received fewer hours during the follow-up period."As I've hinted before on this blog, parent-led interventions when it comes to autism have historically been met with varying degrees of success when experimentally tested (see here). By saying this, I'm not trying to poo-poo such efforts; merely that discussions about how early intervention for autism is the gold standard are all well and good, but exactly what form that early intervention takes has yet to be authoritatively decided bearing in mind the pluralisation of the label (see here). In more recent times, we have seen some slightly more optimistic results appearing with specific interventions in mind, as per previous preliminary results based on very, very early implementation of something like ESDM (see here) and the use of ABA possibly linked to those 'optimal outcomers' (see here). But there is still a lot more to do in this area of research before any big promises are made.Insofar as the idea that intensive efforts in the early years might pay more cost-effective dividends as time goes on, I'm sure that a few eyes and ears will have been grabbed [3] by such a sentiment in these times of continued austerity and resources being squeezed. As I suggested in a previous post (see here) on the idea that parent training might be superior over parent education [4] when it comes to facets of autism, such squeezes to finances/resources might not necessarily translate great experimental results into great real-world outcomes without some blue-sky thinking about how such programmes can be delivered mindful of costs. Estes et al seem to suggest that 'early and intensive' might be eventually able to give way to 'less and sustained'.One last thing: I'm minded to take readers back to the post I wrote concerning the paper by Barnevik Olsson and colleagues [5] and the idea that 'tackling' core autism symptoms is a noble cause but that one has to be mindful of all of the other comorbidity that can follow a diagnosis and can seriously impact on behaviour and development. What perhaps I would like to see a lot more of in lots of areas of intervention with autism in mind, is how said program/tool/schedule also impacts on comorbid features and whether those variables should be the more important factors related to outcome. Sort of like what has been talked about the dietary intervention and autism in mind...Music: Paul McCartney & Wings - Live And Let Die.----------[1] Estes A. et al. Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder. J Am Acad Child Adolesc Psychiatry. 2015. April 28.[2] Dawson G. et al. Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics. 2010 Jan;125(1):e17-23.[3] Penner M. et al. Cost-Effectiveness Analysis Comparing Pre-diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario's Autism Intervention Program. J Autism Dev Disord. 2015 May 5.[4] Bearss K. et al. Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial. JAMA. 2015 Apr 21;313(15):1524-33.[5] Barnevik Olsson M. et al. “Recovery” from the diagnosis of autism – and then?  Neuropsychiatric Disease and Treatment. 2015. 11: 999-1005.----------Annette Estes, Jeffrey Munson, Sally J. Rogers, Jessica Greenson, Jamie Winter, & Geraldine Dawson (2015). Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder J Am Acad Child Adolesc Psychiatry : 10.1016/j.jaac.2015.04.005... Read more »

Annette Estes, Jeffrey Munson, Sally J. Rogers, Jessica Greenson, Jamie Winter, & Geraldine Dawson. (2015) Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder. J Am Acad Child Adolesc Psychiatry. info:/10.1016/j.jaac.2015.04.005

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