George Frankl: an undervalued voice in the history of autism

This paper aims to propose that the psychiatrist George Frankl had more than a marginal role in the early history of autism. Frankl’s conception of autism as characterized by a lack of affective language has influenced both Asperger and Kanner. First, this proposal is historically supported; second it is corroborated by Frankl’s unpublished manuscript on Autism. We found that Frankl’s perspective about autism was, and still can be, considered innovative for multiple reasons. Specifically, Frankl proposed that autism could cover a spectrum of conditions; that it is a state of mind that is not necessarily abnormal; and that it is a neurobiological condition, which primarily needs to be understood by others. Finally, Frankl’s concepts of affective contact and affective language are reconsidered with reference to contemporary neuropsychology from which autism emerges not as a higher-order cognitive deficit, but as a result of an impairment of primordial ability to process low level sensory, motor and perceptual information gained through experiencing other persons

Decompensated cirrhosis as presentation of LKM1/LC1 positive type 2 autoimmune hepatitis in adulthood. A rare clinical entity of difficult management

Background: Autoimmune hepatitis (AIH) is a chronic and aggressive liver disease that rapidly evolves into cirrhosis and end-stage liver disease if not timely diagnosed and treated with immunosuppressive therapy. AIH is classified into type 1 and type 2 according to the autoantibody pattern, with smooth muscle antibodies and/or antinuclear antibodies as serological markers of AIH-1, while antiliver cytosol antibody type 1 and/or antiliver/kidney microsomal antibody type 1 characterize type 2 AIH, which mainly affects children, including infants, and adolescents. Case Summary: We describe a case of type 2 AIH, clinically onset in a 34-year-old woman with decompensated cirrhosis. Only a thorough analysis of the autoantibody profile allowed for a diagnosis of an AIH-2 evolved into cirrhosis. The patient received a moderate corticosteroid therapy without achieving optimal disease control. We discuss the controversial decision of whether or not to treat the patient with immunosuppressive therapy, which should be balanced with the potential risk of infectious and other complications. A review of the literature on the management of patients with autoimmune cirrhosis is also presented. Conclusions: AIH-2 can be clinically onset in adult patients with cirrhosis and its complications, without being preceded by major clinical signs. Due to the difficult management of cirrhosis with immunosuppressive treatments, a patient-tailored strategy with a case-by-case approach is needed to prevent major complications such as infections, potentially precluding liver transplantation the only curative therapy

Acute liver injury and anorexia nervosa: A case report

Anorexia nervosa is an eating disorder characterized by restriction of energy intake leading to a significant decrease in body weight. While it is primarily a psychiatric disorder, numerous medical complications can occur. In this article we describe a case of a 25-year-old woman with a 12-year history of severe restrictive anorexia nervosa that was referred to the Emergency Service of our Hospital, transferred from a psychiatric institute, for severe weight loss, dehydration, and progressive increase in transaminases. During the hospital stay she developed an acute liver injury with an increase in transaminase level up to 40× the ULN. Infective and immunological causes of acute hepatitis were excluded. In the suspect of severe starvation acute liver injury, we performed a nutritional assessment and started parenteral nutrition. After 15 days of parenteral nutrition, she gained 2.5 kg of body weight and liver tests were drastically reduced and nearly normal

Digestibilidad in vivo y consumo voluntario de Digitaria eriantha Steudel subsp. eriantha diferido en carneros

En la Región Pampeana Semiárida se halla muy difundido el pasto llorón (Eragrostis curvula) cuyo forraje diferido y utilizado con bovinos de cría les ocasiona pérdidas importantes de peso vivo. Por esta razón se están realizando numerosos ensayos con gramíneas de crecimiento estival para encontrar aquellas que presentan mejor calidad como diferido. En el presente estudio se evalu6 Digitaria eriantha Steudel subsp. eriantha, difiriendo el forraje producido durante todo su periodo de crecimiento (primavera, verano y otoño) hacia el invierno. Se utilizaron 20 carneros Pampinta, divididos al azar en cuatro grupos de cinco carneros cada uno, a los que se asignaron los siguientes tratamientos: 0.5, 1.0, 1.5 y 2.0 del nivel de mantenimiento. Se midió consumo voluntario y digestibilidad de la materia seca, consumo de materia seca digestible y consumo de lámina. Se utilizó el método de colección total de heces. El forraje se suministró 2 veces por día durante 15 días, el periodo de medición abarco los últimos 8 días. Los resultados obtenidos indican que esta especie utilizada como diferido presenta una buena calidad. Los animales mostraron una fuerte preferencia por la fracción lamina, la digestibilidad del forraje está claramente asociada a la relación entre las fracciones lamina: tallo, por lo tanto, a mayor oferta forrajera, mejor performance animal