Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial

<p>Abstract</p> <p>Background</p> <p>Several uncontrolled studies of hyperbaric treatment in children with autism have reported clinical improvements; however, this treatment has not been evaluated to date with a controlled study. We performed a multicenter, randomized, double-blind, controlled trial to assess the efficacy of hyperbaric treatment in children with autism.</p> <p>Methods</p> <p>62 children with autism recruited from 6 centers, ages 2–7 years (mean 4.92 ± 1.21), were randomly assigned to 40 hourly treatments of either hyperbaric treatment at 1.3 atmosphere (atm) and 24% oxygen ("treatment group", n = 33) or slightly pressurized room air at 1.03 atm and 21% oxygen ("control group", n = 29). Outcome measures included Clinical Global Impression (CGI) scale, Aberrant Behavior Checklist (ABC), and Autism Treatment Evaluation Checklist (ATEC).</p> <p>Results</p> <p>After 40 sessions, mean physician CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0008), receptive language (p < 0.0001), social interaction (p = 0.0473), and eye contact (p = 0.0102); 9/30 children (30%) in the treatment group were rated as "very much improved" or "much improved" compared to 2/26 (8%) of controls (p = 0.0471); 24/30 (80%) in the treatment group improved compared to 10/26 (38%) of controls (p = 0.0024). Mean parental CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0336), receptive language (p = 0.0168), and eye contact (p = 0.0322). On the ABC, significant improvements were observed in the treatment group in total score, irritability, stereotypy, hyperactivity, and speech (p < 0.03 for each), but not in the control group. In the treatment group compared to the control group, mean changes on the ABC total score and subscales were similar except a greater number of children improved in irritability (p = 0.0311). On the ATEC, sensory/cognitive awareness significantly improved (p = 0.0367) in the treatment group compared to the control group. Post-hoc analysis indicated that children over age 5 and children with lower initial autism severity had the most robust improvements. Hyperbaric treatment was safe and well-tolerated.</p> <p>Conclusion</p> <p>Children with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air.</p> <p>Trial Registration</p> <p>clinicaltrials.gov NCT00335790</p

The Role of Guide Wire in Internal Urethratomy Under Direct Vision

Background & aim: Urethral Stricture (US) is a common urolologic problem. Direct optic internal urethratomy (DOIU) is a common option for treating US. The purpose of this study was to investigate the role of the guide wire to facilitate direct vision internal in adult male patients. Methods: In this prospective study, 84 patients with anterior urethral stricture randomly divided into two groups. The first group underwent routine DOIU surgery and the second group internal urethratomy was carried out using Wolf ureteroscope 8-9.8 French and guide wire 0.035 French which inserted into bladder. Data were collected and analyzed using software (spss). Results: The mean operation time was 14 minutes in group one and for group 2 was 10 minutes. The comparison of complications after surgery showed that in the first group urethral bleeding accrued in 4 patients (9.52%) and fever infection was seen in 3 patients (7.14%) respectively but no such events were observed in group 2. The only late complication in both groups was recurrence of the stricture that was seen in 8 patients (19.04%) of group one and 3 patients (7.14%) of group 2. Conclusions: The results of this study showed that using a guide wire during DOIU may facilitates the procedure shortens the operation time and reduce the effects of short and long-term operation