Behavioural and Developmental Interventions for Autism Spectrum Disorder: A Clinical Systematic Review

Background: Much controversy exists regarding the clinical efficacy of behavioural and developmental interventions for improving the core symptoms of autism spectrum disorders (ASD). We conducted a systematic review to summarize the evidence on the effectiveness of behavioural and developmental interventions for ASD. Methods and Findings: Comprehensive searches were conducted in 22 electronic databases through May 2007. Further information was obtained through hand searching journals, searching reference lists, databases of theses and dissertations, and contacting experts in the field. Experimental and observational analytic studies were included if they were written in English and reported the efficacy of any behavioural or developmental intervention for individuals with ASD. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively and, where possible, meta-analyses of the study results were conducted. One-hundred-and-one studies at predominantly high risk of bias that reported inconsistent results across various interventions were included in the review. Meta-analyses of three controlled clinical trials showed that Lovaas treatment was superior to special education on measures of adaptive behaviour, communication and interaction, comprehensive language, daily living skills, expressive language, overall intellectual functioning and socialization. High-intensity Lovaas was superior to low-intensity Lovaas on measures of intellectual functioning in two retrospective cohort studies. Pooling the results of two randomized controlle

LetterRaising a mentally ill son

No abstract available for this letter.Journal of Child and Adolescent Mental Health 2008, 20(1): 53–5

Facteurs prédictifs pré-opératoires de transfusion sanguine en chirurgie cardiaque de l'adulte

POITIERS-BU Médecine pharmacie (861942103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

La mise en place d'une politique d'extubation précoce en chirurgie cardiaque pour pontage aorto-coronarien sous CEC [circulation extra-corporelle] s'accompagne-t-elle d'une réduction de la morbidité, de la mortalité et de la durée de séjour en unité de soins intensifs ?

POITIERS-BU Médecine pharmacie (861942103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Incidence du taux d'antithrombine sur les thromboses de filtres d'hémofiltration en post opératoire précoce de chirurgie cardiaque

POITIERS-BU Médecine pharmacie (861942103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study.

MAIN OBJECTIVES:To estimate the incidence of active bleeding after cardiac surgery (AB) based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications. METHODS:AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration) were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: "Low incidence" if incidence is lower and "High incidence" if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications. RESULTS:Among 4,904 patients, 129 experienced AB (2.6%), among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16%) but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication. CONCLUSIONS:A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring early after surgery

Risks factors of occurrence of at least one postoperative complication.

<p>Univariate and multivariate analyses.</p

Postoperative management during the first 24 hours.

<p>Values are presented as N(%) or Median [Q25;Q75]. Significant difference between “Low incidence” and “High incidence” are denoted by *p<0.10, **p<0.05 and ***p<0.01, tested by Student /Mann-Whitney tests or Chi²/Fisher tests.</p

Preoperative characteristics (<i>N = 129)</i>.

<p>Values are presented as N(%) or Median [Q25;Q75]. Significant difference between “Low incidence” and “High incidence” are denoted by *p<0.10, **p<0.05 and ***p<0.01, tested by Student /Mann-Whitney tests or Chi²/Fisher tests.</p